Perspectives on Challenges in Updating NSLP and SBP Meal Patterns and Nutrient Standards

Transcription

1 Perspectives on Challenges in Updating NSLP and SBP Meal Patterns and Nutrient Standards Jay Hirschman, M.P.H., C.N.S. Director, Special Nutrition Staff USDA Food and Nutrition Service Office of Research and Analysis July 9, 2008

2 Thank you National Academies Institute of Medicine Food and Nutrition Board All committee members and staff All interested parties who will speak today

3 Statement of Work: Critical Issues for Consideration 1. Calorie Requirements 2. Age/grade groups 3. Nutrient standards 4. Total fat 5. Available nutrient information 6. Sodium standard 7. Vitamin A standard (IU-RE-RAE) 8. Menu planning approaches 9. Fruit, vegetables, whole grains and low fat/fat-free milk products 10. Meat/meat alternate 11. Offer versus serve 12. Attainable recommendations These issues were discussed at the June 11 th open meeting

4 Challenge: D jour v. Consensus Perspective: Scientifically-based public policy must consider the historical research and preponderance of evidence, not just the latest hot topic study. In 1675, Isaac Newton said If I have seen further it is by standing upon the shoulders of giants. Today, we tend to say: We reach great heights because we stand on the shoulders of giants This effort cannot review the full depth of scientific information considered in developing the DRIs or the Dietary Guidelines for Americans. They are the shoulders on which we stand, and therefore: These should be taken as the scientific foundation upon which decisions are based. In addition, the DGAs are approved Federal policy, and both the DGAs and DRIs are by law applicable to NSLP and SBP.

5 Challenge: Translating DGAs and DRI in Food-Based Meal Patterns Perspective: Historically, meal patterns have been built by drawing on scientifically-based and consensus-supported food guides. Similar to the long history of scientific research and experiential refinement that underpins the DRIs, there is a similar long history of scientific research and experiential refinement that underpins some of the available food guides The DGA-2005 publication includes two food guides: the DASH diet and the USDA Food Guide However

6 Challenge: Group Planning Most goals for nutrient adequacy [for the USDA Food guide] were based on the RDAs or AIs because the food intake patterns are designed for use by individuals in planning their diets rather that for planning group intakes. Britten et al. J Nutr Educ Behav, 2006:38:S82 Perspective: Applying the DRI group planning model would seem to require establishing target percent inadequate levels for each EAR nutrient. Two challenges include: The DRI reports provide no scientifically-based guidance on the relative risks among nutrients of various levels of percent inadequate to guide selection of the targets It is not clear how to translate intake targets into minimum and/or maximum meal pattern requirements at the offered and served levels

7 Challenge: Overweight Perspective: Given the epidemic of child overweight and adult obesity, and their known long-term adverse health consequences, school meals must contribute to overweight prevention Current and historical meal patterns and standards have focused on providing at least the minimum quantities of food It is now time to consider the need for both minimums and maximums It may be possible to use the lunch age/grade ranges in a manner that avoids offering high-school sized meals to elementary school students, e.g., if calorie ranges do not overlap

8 Challenge: How to balance preventing hunger and preventing overweight Perspective: Most childhood overweight is probably not due to children eating too much highly nutritious food.

9 Challenge: Improving Consumption Perspective: What really matters is what the children eat, not simply what we offer to them or what they select. We must provide balanced meals from a total diet planning perspective. A child who eats an NSLP and SBP meal every school day could consume ¼ of their annual food intake from school meals. Routine monitoring of food consumption at each school is not practical. One specific intent of the School Meals Initiative for Healthy Children was to hold schools responsible for what students select, as an indicator of foods consumed.

10 Challenge: Keeping it Simple Perspective: Increased complexity is likely to increase unintentional regulatory non-compliance It is possible that requirements based on a few good key indicators could be better at achieving results than a long list of detailed requirements

11 Challenge: Maintaining a System that Promotes Compliance and Can be Monitored Perspective : The cashier needs to be able to tell with great accuracy if it s a reimbursable meal in a few seconds just by looking at the tray. Ditto for their manager and an outside monitor.

12 Challenge: Promoting Naturally Nutritious Foods Perspective : A basic premise of the Dietary Guidelines is that nutrient needs should be met primarily through consuming foods. (DGA 2005, p. vi) Requiring very high vitamin or mineral nutrient density could encourage fortification rather than improved food offerings

13 Challenge: Milk fat and flavoring Perspective 1: The DGAs admonition to consume fat-free of low-fat milk or equivalent milk products should be reflected in the updated meal pattern recommendations Perspective 2: Added sugars themselves do not provide vitamins and minerals, and they use up discretionary calories needed for menu planning flexibility. However, kids prefer flavored milk (mostly chocolate milk with added sugars) About 2/3 of the NSLP participants who consume milk at lunch choose flavored milk [SNDA-III, Vol.2, p178]

14 Challenge: Whole Grains Perspective 1: Fiber and whole grains are not synonymous, and whole grain products are different from whole grains Perspective 2: To paraphrase an old adage: You can lead children to whole grains, but you can t make them eat them. The DGAs indicate that all age groups should consume at least half their grains as whole grains Offering children a daily choice between whole grain and non-whole grain can result in infrequent selection of whole grains, but offering only 100% whole grains may affect participation

15 Challenge: Promoting Access to School Breakfast Perspective : Just as children are not little adults, the operational differences between school breakfast and school lunch are profound enough to justify different policies in some areas. The challenge here is to afford SFAs enough flexibility in SBP to continue promoting access, success and hunger prevention, while providing: regulations that achieve nutrition improvement, and enough conformity to NSLP to achieve efficiency Examples of possible policy areas where differences may be justified include: Age/grade groupings Fruits and vegetables (one group or two)

16 Challenge: Offer versus Serve (OVS) Perspective: The OVS guidelines can be altered, as needed, to fully support the committee s recommendations, but the student choice concept that OVS represents should be recognized as an important part of the school food service. Offered versus Serve (OVS) is required by law for secondary students, and optional at the school level for elementary students. It is intended to reduce waste by not requiring students to take food they will not eat. It also helps control cost by letting schools prepare only the quantity of food they know will be selected by the students. The OVS rules are considered to be a critical component of the school meal programs, and provide the student customers with the ability to make choices and participate in their lunch or breakfast experience each day, rather than simply picking up a meal already selected for them. The OVS rules currently vary by meal planning system

17 Challenge: Cost Perspective: provide revised NSLP and SBP meal pattern and nutrient standard requirements that are as practical and economical as possible. minimizing increases in cost is an important consideration; changes in requirements should be designed to keep program costs as close as possible to current levels (adjusted for inflation). [quote from Statement of Work] We are seeking to establish updated program requirements that reflect the advances in scientific knowledge and consensus Reimbursement rates are established in the National School Lunch Act without any discussion of what portion of the meal cost they are expected to support. On average, food comprises only 37 percent of the full cost of producing school meals. The balance is mostly labor. The meal cost at any school is dependent on a number of factors and decisions about food service for the school or district. Choices concerning meal preparation techniques such as on site or satellite preparation, labor policies, menus and other school by school differences, such as kitchen design and equipment, have an effect on cost. More than 25 percent of SFAs manage at or below the NSLP free meal reimbursement rate.

18 Questions? NOTE A few additional slides for the record follow

19 Challenge: Sodium Perspective: Don t get hung up on sodium early in the process; it may be best addressed near the end stage of meal pattern development The American diet in general is high in sodium relative to the DRI Tolerable Upper Intake Level (UL) Keeping sodium to acceptable levels has been a challenge in most food planning efforts (e.g., the Thrifty Food Plan; the USDA Food Guide in DGA-2005) Due to taste acclimation, consider stepwise reduction over time. A total population effort may be needed to be successful

20 Sodium in NSLP Meals SNDA Study Findings for , and UL 2000 Offered Served SMI Maximum n/a SNDA SNDA SNDA Blue numbers = extrapolated n/a = not available

21 Challenge: Rounding Perspective: Round only once, at the last stage of the calculation process. As a practical matter, minimum and maximum portion sizes will need to be rounded to reasonable units of measure for field use There is great temptation to round at various stages in the development process, but doing so runs the risk of compounding rounding errors Remember that food service units are in English measures, especially cups, ounces and fluid ounces, while nutrients are usually in metric units

22 Challenge: Achieving Meal Excellence Perspective: The achievement of the HealthierUS School Challenge schools shows that highly motivated SFAs can provide highly nutritious meal service. It may be helpful to the Committee to obtain input and perspective from the high achievers, the Gold schools, including inspection of their menus and recipes While the HealthierUS School Challenge certified schools are high achievers, they may not be meeting all of the DRIS and DGAs. Improved rules should continue to allow the overachievers to excel, and do better in compelling those in the lower realms of the quality distribution to improve. In part, this requires providing them the added ability needed to improve.

23 Challenge: Balancing Innovation and Risk Perspective: Some things need to be pilot tested and evaluated, and possibly even iteratively refined, before nationwide implementation Nutrient Standard Menu Planning was tested and refined 3 times (1970 s, 1980 s and 1990 s) before being established in regulation