Winning Public Support for Healthy Eating in Schools

Transcription

1 Winning Public Support for Healthy Eating in Schools Mary McKenna, PhD, RD University of New Brunswick Fredericton, NB, Canada Nashville, TN, 10 July 2011

2 Overview What Models of school nutrition Why, When, Where and How Strategizing for improvement Who Roles for food service

3 School Nutrition in Canada No federal mandate Little funding, no oversight No national programs All 10 provinces and 1 (of 3) territories have school nutrition policies, either Province-wide policy Mandates for districts to develop and implement policy Voluntary provincial guidelines

4 Models of School Nutrition Traditional Hybrid Home-style

5 Model I: Traditional Wide choice of foods and beverages Meals & competitive foods Nutritional range reflects the real world Educate students to make wise decisions

6 Lunch Sales in NB School Soft drinks (43) French fries (40) Poutine (37) Pizza (30) Chocolate milk (29) Salad (0) White milk (0) Apple (0) Juice (0) Water (0)

7 Model II: Hybrid Narrower choice of foods and beverages Increased emphasis on meals Restrictions on competitive foods Increased emphasis on nutrition Guided by nutrition standards Healthier versions of fast foods Increased ease for students to make healthier choices, desire to improve health outcomes

8 Lunch Sales in NB School chocolate milk 90 pizza 49 white milk 33 slush puppies 33 cookies 19 burgers 12 cinnamon buns * 3 juice * 2 strawberries * 1 potato * 1 special

9 Now: Pizza and Milk instead of Fries and Soda

10 Healthier Versions

11 Full Meals Are Available but Uptake is Low

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16 From 1997 to What is Different? No deep fat fried food A few more whole grains Fewer foods and beverages with low nutrition value Non-food fundraisers Increased acceptance/less overt resistance to nutrition More nutritious packaged foods brought from home What is Similar? High sales of a few items Low availability and sales of vegetables and fruits Low sales of complete meals Customer-oriented food service staff Wide variation in nutrition quality of food brought from home

17 Food Services Heavy reliance on food services to implement provincial school nutrition policy Limited Links between food services and classrooms Classroom nutrition education Nutrition cues within school environment Health services related to food Outreach to families and community

18 Model III: Home-style Choice is school meal(s) or food brought from home No competitive foods except vegetable, fruit, or milk snack programs (i.e., no a la carte, vending machines, canteens) Healthy, appealing meals & snacks only A school model based on a healthy home where choice is limited can reinforce positive eating habits

19 Healthy Eating at Eskɨnuopitijk K-8 School, NB One meal choice daily Students are encouraged to take some of each item Cost $1/day (subsidized by band) Fish once per week Planning to increase local foods and whole grains School snack and breakfast program

20 Eskɨnuopitijk Results (170 lunches per day) Almost 100% uptake Relatively little waste

21 Comparing the Models Models Choice Cost Appeal School role Traditional Wide Less of an issue Hybrid Narrower More of an issue Wide Varying Educate for real world Compromise real world/ health Home-style Minimal Subsidization required (?) Careful planning needed Educational institution role models healthy eating

22 The Models in Action Evidence Studies have found that greater access to less nutritious foods and beverages at school is associated with increased intakes of total calories, soft drinks, total fat, and saturated fat increased body mass index decreased intakes of fruits, vegetables, milk, and key vitamins and minerals

23 Rationale for Improvement Public health Academic performance Economics Social justice (access to food) National security Environmental health Community wellbeing (Rethinking School Lunch 2 nd edition)

24 Recommendations Robert Wood Johnson Foundation CDC Institute of Medicine... Feed children only healthy foods in schools

25 Policies California Competitive food items may have no more than: 35% calories from fat (excluding legumes, nuts, nut butters, seeds, eggs, non-deep fried vegetables, and cheese packaged for individual sale.) 10% of its calories from saturated fat (excluding eggs and cheese packaged for individual sale). 35% sugar by weight (excluding fruits and vegetables). 175 calories for items sold in elementary schools. 250 calories for items sold in middle and high schools. Individually sold entrees may not have more than: 4 grams of fat per 100 calories 400 calories Must follow the federal reimbursable meal requirements

26 Home-Style Model in Action Exchange at a school cafeteria Interviewer: Would you rather be eating a cheeseburger? Student: No, no way Interviewer: Why not? Student: This is more healthy. This exchange occurred in: A. Canada B. England C. Finland D. United States

27 Finland: The Plate Model 1/4 meat, fish or egg 1/2 cooked and raw vegetables 1/4 potatoes, rice or pasta (whole grain) 2 pieces corn bread fat-free milk or buttermilk ortal/en/nutrition_recommendations/

28 USA School Meals Meet MyPlate Simple, clear approach to School meals

29 Strategizing for Improvement Arguments and Counter-Arguments For every argument to improve school foods a counter-argument exists (and vice versa)

30 Arguments for Healthy Food Cost Choice Appeal School role In our school, it s the children who profit Competitive foods can have a negative impact on school foodservice finances (Peterson, 2011) Schools can make money selling healthy, appealing, wellmarketed food (Making It Happen) Less choice increases economy of scale, decreases waste (?) Students given wide choices make poorer selections Students often get little choice at home Limited choice simplifies decision-making Students have limited choice in many aspects of their education Healthy food can be presented and marketed well Student involvement (e.g., local foods) increases appeal Price differentials increases appeal Schools educate by the choices they present As educational institutions, schools that offer food have a responsibility to ensure it contributes to the student s education

31 Strategizing for Improvement Lack of Predictability Strengths contributing to the development of LWP: school staff expertise (87%), administrative support (80%), personal commitment (77%) and personal perspective (71%) (NFSMI, 2010) While many people support improved school nutrition, it is not universal Support or opposition to improved school nutrition cannot be predicted by the person s profession or role

32 Strategizing for Improvement Views of Key Stakeholders Public/parents Students School boards Industry Food service

33 Public/Parents 78% of US voters believe that schools should be required to meet higher nutrition standards for all foods they serve or sell to students 61% support providing schools with more funding to meet those standards Pew Trust, 2011

34 Students.. our school has begun to make better salads, sandwiches, and wraps. These items have great presentation, which makes them more appealing...i wish more fresh fruit were offered. Healthy is always a plus. I believe that we should push for all healthy food. I am so lucky that my school has good food! We have a salad bar and even our soups are low sodium. Robert Wood Johnson Foundation

35 School Boards (NSBA - paraphrased) Child nutrition is vitally important Programs can t be successful unless school districts have sufficient resources and authority to administer them Local successes due to increased awareness and education, not federal mandates, will spur needed change NSBA Issue Brief on Child Nutrition

36 Food Industry Alliance for a Healthier Generation School Meals Agreement to increase the availability and affordability of healthier products for school districts Goal: > 50% of food sales meet Alliance school meal standards Participants: food manufacturers, group purchasing organizations, technology collaborators, and supporting organizations

37 Food Service Healthy, Hunger-Free Kids an important and leading step in the many that must be taken to improve the health of school children through providing more nutritious foods 100% involvement in developing & implementing LWP (NFSMI, 2010) Operational responsibility (48% of districts; 19% of schools) (NFSMI, 2010)

38 Feasibility Concerns Overall costs/resources Procurement Labour Skills Equipment Space/storage Timing» Rice, 2010 (SNA)

39 Roles for Food Service Your views? Personal views Nutrition Role of school food your role specifically Students/customers Effective approaches Personal experience, attitudes Eating, health, relationship with food Professional experience Change process and communications Working relationships Supports and challenges

40 Roles for Food Service Knowledge of issues Awareness of and use of resources and supports Awareness of likely challenges and ideas for strategies to address them SNA, NFSMI, USDA, CDC, RWJF, AHG, AFHK, Let s Move, ADA, and more!

41 Ecological Framework-Student Eating in Schools MACRO-LEVEL policies, politics, publicity, media, government, nongovernmental organizations, industry SCHOOL LEVEL community connections, administration, personnel, education of students, school location, health services, advertising/ promotions, food suppliers, school policies McKenna, 2011 NEAR ENVIRONMENT parents/home, peers, programs and foods available in schools STUDENT behaviours, attitudes, knowledge, skills, self concept, background

42 Roles for Food Service Meaningful engagement of key stakeholders Begin with the people whose eyes light up Students: student engagement in school nutrition policies increases acceptance (Jomaa et al, 2010) Parents, suppliers, administrators and educators, local media, etc.

43 Opportunities for Policy Education Conduct literate taste testing Create advertisements and healthy eating promotions Analyze foods relative to nutrition standards Compare and contrast different nutrition standards Analyze the policy process Monitor policy implementation Assist with marketing the policy Participate in school health/ nutrition committees

44 Roles for Food Service Key champions High profile public, local, powerful (formal and informal) Positive connections Local food (school gardens, farm visits, promotion of local food)

45 Roles for Food Service Sources of motivation Specific, measurable, time-measured goals Experiences of others (SNA, USDA/CDC, NFSMI, RWJF, AFHK) External grants Recognition programs (USDA, Alliance) Competitions (student chefs, apps contest) Positive publicity Monitoring, evaluation, feedback Tracking, responding, sharing

46 School Health Success (Thomas, 2010)

47 Summary The evolution of school foods is towards healthy foods and beverages the home-style model Consider arguments and counterarguments, lack of predictability, and key stakeholders when strategizing for improvement

48 Summary Food service personnel have played critical roles in improving school nutrition and will continue to do so in future A self-assessment can be useful Addressing macro- and micro-level influences on student eating habits may enhance success

49 Bottom Line We will know the cultural norm has shifted when people stop defending unhealthy food in schools»mckenna, 2011

50 Thank You Mary McKenna Faculty of Kinesiology, PO Box 4400, University of New Brunswick, Fredericton, NB, Canada. E3B 5A3