December 2010





House Sends Child Nutrition Bill to President Obama

Dec. 3, 2010, The Washington Post

By Nick Anderson

The Democrat-led House voted to send President Obama a bill that would enable more poor children to receive free meals at school, raise the nutritional quality of cafeteria fare and reduce the junk food and sugary beverages sold in school vending machines.

The bill, which cleared the Senate in the summer, won House approval on a 264 to 157 vote. Seventeen Republicans broke party ranks to join Democrats in favor of the bill. Four Democrats were opposed.

The bill, a priority for the president and first lady Michelle Obama, would boost spending on child nutrition $4.5 billion over 10 years and raise federal reimbursements for school lunches more than the inflation rate for the first time since 1973. It also would require for the first time that free drinking water be available where meals are served.

The bill accelerates the budding healthful-food movement in public education – think whole wheat pizza with lowfat cheese and low-sodium sauce – but leaves unanswered key questions about whether schools can afford to give tens of millions of students better meals.

Democrats took steps to offset the bill’s costs, including a $2.2 billion cut to food stamp benefits for needy families. Those maneuvers, reflecting political pressures to avoid adding to the budget deficit, caused many Democrats to wince even as they voted for the bill because it would effectively shift funds from one anti-hunger program to another.

House Republicans opposed the bill as a needless expansion of government by the lame-duck Congress weeks after voters punished Democrats at the polls. National groups representing school administrators and boards also were opposed, calling the bill an unfunded mandate that would strain strapped school budgets.

But the Senate approved the bill through unanimous consent in August. It had strong backing from an array of groups seeking to improve child nutrition and has become part of the first lady’s campaign against childhood obesity and hunger.

For House Democrats, approval of the bill marked a show of force a month before they cede the gavel to a new Republican majority.

“In a country as great as ours, no child should go hungry,” Rep. George Miller (D-Calif.), chairman of the Education and Labor Committee, said Wednesday. But he added that many do. “We cannot afford to let that continue.”

Rep. John Kline (R-Minn.), the incoming committee chairman, said Democrats were flouting the will of the voters. “ ‘Stop growing government,’ people are telling us,” Kline said. “ ‘Stop spending money we do not have.’ It’s a simple request and a sensible one. Yet it continues to be ignored.”

Republicans proposed Wednesday to amend the bill, including a requirement for background checks for certain child-care providers, and thereby force another vote in the Senate that would jeopardize the bill’s chances of becoming law.

To neutralize that threat, Democratic leaders staged a vote on – and passed – a separate measure that mirrored elements of the Republican proposal. Then they muscled the nutrition bill, unamended, through its final vote.

The nutrition bill, steered through the Senate by Sen. Blanche Lincoln (D-Ark.), seeks to expand access to subsidized meals for needy children and ensure that those meals have more whole grains, lean proteins and fruits and vegetables. The national school lunch program serves 31 million children, with more than 62 percent receiving free or reduced-price lunches.

Key provisions of the legislation would:

  • Use Medicaid data in some states to enroll children automatically for free meals. That would add about 115,000 new students each year to the program. Experts say needy families often fail to fill out paperwork required to show their eligibility. This provision would address that problem.
  • Expand an after-school supper program for the needy – now offered in the District, Maryland and 12 other states – to all states. Doing so would provide an additional 21 million meals annually.
  • Authorize the establishment of nutrition standards for all food and beverages sold on school grounds throughout the school day. Currently, the government’s regulatory scope is limited to cafeterias during hours when meals are served. This provision, advocates say, would force out sugary beverages and snacks and clear the way for more healthful food and drinks to be offered through a la carte sales at snack bars and vending machines.
  • Raise the federal reimbursement by 6 cents per lunch for school districts that comply with new meals standards to be issued by the Agriculture Department. The reimbursement rate is now $2.72 for each free lunch, which most school administrators say is insufficient to cover costs.The 6 cent increase, like the base rate, would be indexed to inflation.

The American Association of School Administrators, the National School Boards Association and the Council of the Great City Schools opposed the bill, saying it would impose a host of requirements without providing schools money to pay for them.

Jeff Simering of the Council of the Great City Schools said the bill’s advocates won’t suffer the fiscal headaches of implementing it. “They don’t have to balance a budget,” he said. “They can take positions on issues that a lot of us would like to support.”

Diane Pratt-Heavner of the School Nutrition Association described the bill as “our best chance” for getting more money for school meals. “Whether a child is in the cafeteria ordering a school meal or in front of a vending machine or in an a la carte line,” she said, “they’ll be receiving a consistent message about healthy food choices.”


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2011 Built Environment Assessment Training (BEAT-Plus) Institute

June 26-July 1, 2011, Seattle, Wash.

The built environment, which is made up of the nutrition and physical activity environments, streetscapes, transportation environments, and everything in between, has been identified as a key determinant in the obesity epidemic. Therefore, understanding how environmental and policy changes can inform efforts to control obesity, improve diet and physical activity, is a priority.

A variety of measures now exist that allow researchers and practitioners to plan and evaluate changes to the built environment. The Built Environment Assessment Training (BEAT) Institute is designed to train participants to use these measures for research and practice.

The goals of the BEAT Institute are to: 1) Prepare investigators and practitioners to use both observational and self-report measures of nutrition and activity environments and related behavioral assessments through lectures, fieldwork, hands-on skills, group work and individual consultation and 2) Increase the number of professionals qualified to conduct built environment assessments for nutrition and physical activity.

For more information, see our website.

(Funding through the United States Department of Agriculture, with support from the Center for Health Behavior Research at the University of Pennsylvania.)

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Publications & Tools

Report Highlights Changes Needed to Support Healthy Eating and Physical Activity in U.S. Elementary Schools

Nov. 23, 2010, RWJF Childhood Obesity News

By L Turner, FJ Chaloupka, JF Chriqui and A Sandoval

A comprehensive new report from Bridging the Gap and the Robert Wood Johnson Foundation shows that elementary schools across the nation commonly offer their students junk food and soda, serve meals that don’t meet current dietary guidelines, and provide little time for physical activity.

The report, School Policies and Practices to Improve Health and Prevent Obesity: National Elementary School Survey Results, examined practices that affect nutrition, physical activity and obesity prevention for tens of millions of students. Its conclusions are critical for informing the Child Nutrition Reauthorization legislation, including policies related to competitive foods and school meals.

Among the key findings from the 2007–08 school year:

  • Nearly two-thirds of public elementary school students were able to purchase competitive foods or beverages on campus. These items, sold or served outside of school meal programs, often included soda, candy, cookies and french fries.
  • Meals served through the National School Lunch Program often included higher-fat items such as pizza, french fries, and 2% or whole milk.
  • Only 20 percent of public school third-graders were offered daily physical education, and only 18 percent were offered at least 150 minutes of weekly physical education, as recommended by the National Association for Sport and Physical Education.

The report shows that many schools have not implemented the wellness policy provisions required by the Child Nutrition and WIC Reauthorization Act of 2004. That legislation called for school districts participating in federal child nutrition programs, such as the National School Lunch Program and School Breakfast Program, to adopt and implement a wellness policy by the start of the 2006–07 school year.

Results were based on surveys of school administrators during the 2006–07 and 2007–08 school years, and findings represent about 21 million students in kindergarten through fifth grade each year.

The report highlights key findings, presents data in user-friendly figures and tables, and describes policy opportunities. An executive summary was released in June 2010.



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Report Shows Americans Do Not Eat Enough Fruits and Vegetables

A new report card from the National Fruit & Vegetable Alliance, developed by the Produce for Better Health Foundation, shows that there has been little improvement in efforts to increase fruit and vegetable consumption since 2005. The report card evaluated progress made by schools, restaurants, retailers, and federal and state governments. It found that the average American fruit and vegetable consumption remains far below recommended levels. The report recommended increasing fruit and vegetable availability in communities, schools, the work place, and restaurants; strengthening nutrition education programs; and aligning federal funding to be consistent with the federal dietary guidelines.


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Childhood Obesity Research & News

FDA Seeks Nutrition Face Label Format Comments

The Food and Drug Administration (FDA) is seeking public comments on the paperwork and regulatory burden associated with the proposed modifications to the nutrition facts label format. Comments are due by Dec. 17. The FDA Federal Register notice can be read here.

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Highmark Inc. Collaborates with the Alliance for a Healthier Generation

Nov. 29, 2010, PRNewswire

Thirty-nine percent of the children living in Pennsylvania are overweight and are at greater risk of developing such chronic diseases as diabetes, high blood pressure and heart disease than the generation before them. To continue its efforts to address childhood obesity, Highmark Inc. has collaborated with the Alliance for a Healthier Generation to expand its obesity benefits for children in 2011.

“Highmark has signed on to collaborate with the Alliance for a Healthier Generation’s Health Care Initiative to support the goal to provide a holistic approach to the prevention, assessment and treatment of childhood obesity through multiple avenues, including health insurance offerings,” said Dr. Donald R. Fischer, Highmark’s chief medical officer.

“More than 500,000 children will have access to this important care through Highmark. By decreasing the health risks of children, we decrease the number of children who will most likely develop into unhealthy adults. Highmark’s commitment to this endeavor is an investment in the health of the entire community.”

The Alliance for a Healthier Generation, a nonprofit organization founded by the American Heart Association and the William J. Clinton Foundation, works to positively affect the places that can make a difference to a child’s health – homes, schools, doctors’ offices and communities.

“We know that our network physicians are equally concerned about childhood obesity and represent a valuable resource of expertise and caring,” added Dr. Fischer. “Highmark’s participation in this initiative is helping to remove some barriers so that our network physicians can provide the optimal health care and guidance needed to address obesity.”

Starting Jan. 1, 2011, children ages 3 to 18 with a BMI over the 85th percentile for their age are eligible to receive the benefits and will be automatically enrolled. Through a preventive health benefit plan, eligible children will receive a minimum of four follow-up visits with their primary care provider (or other health care professional), along with four visits with a registered dietitian.

“Without proper prevention and treatment of childhood obesity, our current generation could become the first in American history to live shorter lives than their parents,” said Ginny Ehrlich, Alliance for a Healthier Generation executive director. “We applaud Highmark for making this ongoing commitment to help reverse the childhood obesity epidemic.” Highmark has had a deep history in promoting children’s health. The collaboration with the

Alliance for a Healthier Generation will serve as a complement to the existing programs, services and funding that Highmark has been providing to address this national issue. The alliance’s goal of providing comprehensive health benefits for the prevention, assessment and treatment of childhood obesity aligns with Highmark’s mission and the Highmark Healthy High 5 initiative to promote lifelong healthy behaviors in children and adolescents.

Highmark values the Alliance for a Healthier Generation’s long-term goal that more than 6 million children, or 25 percent of all overweight and obese children in the United States, will have access to this benefit by 2012.


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USDA Announces Wellness Grants in the Child and Adult Care Food Program

Nov. 19, 2010, USDA Office of Communications

Agriculture Secretary Tom Vilsack announced Child Care Wellness Grants to 14 states for the improvement of health and wellness in child care settings. More than $7.7 million in funding will support state agencies in implementing initiatives through the Child and Adult Care Food Program (CACFP). Over half of the funds awarded will be distributed to local child care sponsoring organizations and institutions through state agencies.

“Local efforts have the greatest promise to develop, test, and implement successful programs to promote health and nutrition improvement in childcare settings” said Vilsack. “These grants will inspire innovative improvements to enhance nutrition and promote physical activity of the children in these states and communities.”

The Child and Adult Care Food Program (CACFP) plays a vital role in improving the quality of child care and in making care more affordable for low-income families. Through CACFP, more than 3.3 million infants and children and 112,000 adults receive nutritious meals and snacks each day.

During the grant period, ranging from two to three years, states will fund activities that promote nutrition and physical activity in child care that reflect the Dietary Guidelines for Americans and the most recent scientific knowledge; provide technical assistance and training to sponsors and providers of child care centers and family and group day care homes; perform outreach campaigns that increase access to the program in underserved areas and populations; and/or make innovative use of technology to provide training to sponsoring organizations and child care providers.

The 14 states receiving grants are: Alaska ($200,454), District of Columbia ($212,614); Kansas ($954,445); Maine ($564,040); Maryland ($406,401); Missouri ($448,158); Montana ($111,034); Nevada ($349,875); New York ($693,635); North Carolina ($926,708); Oregon ($500,000); Pennsylvania ($684,883); Texas ($1 million); and Wisconsin ($666,922).

Strengthening the Child Nutrition and National School Lunch Acts, which authorize USDA’s child nutrition programs including the National School Lunch and School Breakfast Programs, is the legislative centerpiece of First Lady Michelle Obama’s Let’s Move! campaign. This legislation will help battle hunger and food insecurity during the school day while providing critical resources to raise a generation of healthy children.


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Shopping Vouchers for Walking to School

Nov. 28, 2010, The Telegraph

By Stephen Adams

Children will receive shopping vouchers and cinema tickets simply for walking to school under a scheme aimed at tackling childhood obesity that could be rolled out nationwide.

Andrew Lansley, the Health Secretary, will unveil the walk-for-rewards initiative as part of the Coalition’s white paper on public health.

It will contain a raft of measures aimed at “nudging” people to take better care of themselves, after Lansley concluded that “radical action” was needed to improve the nation’s health.

Under the scheme, pupils will be issued with electronic swipe cards that they use to touch receivers on lampposts between their home and school, in much the same way that Oystercards work on the capital’s transport network.

In a pilot scheme in Wimbledon, southwest London, teenage girls received a £5 Topshop voucher if they walked to school eight times within a certain period, and an Odeon cinema ticket for five days of walking.

As a result there was an 18 percent increase in walking to school. Police time to deal with what organizers termed “overcrowding” at bus stops and on buses also dropped by almost half.

This led to a £24 public saving for every £1 invested in the scheme, according to official figures.

Tam Fry, of the National Obesity Forum, gave the idea a “cautious welcome.” “In principle it’s a good idea, but it needs to be closely monitored,” he said, advising that schools should set their pupils a “time limit” depending on distance.

“It needs to be a brisk walk; they’ve got to huff and puff,” he said. “If they amble to school and stop at the corner shop to buy fizzy drinks, it’s a waste of time, because then they would probably take in more calories than they would expend.”

Almost one in four children starting secondary school in Britain is now either overweight or obese, population studies show.

While the last Labour had pledged to halt the rise in childhood obesity by 2010, it quietly deferred that target to 2020.

Studies consistently show that overweight children tend to grow up into adults who are more prone to heart disease and cancer. Nearly half of pupils (43%) are driven to school by their parents, according to a poll by the campaign group Living Streets, which represents pedestrians. Road accidents and childhood abduction are the biggest fears that stopped them letting their children make their own way to school.

Lansley’s willingness to use what critics might dismiss as bribery to change children’s exercise habits, has its roots in what economist call “nudge economics”.

This is the theory that people will change their behavior if they are given small incentives – either sticks or carrots – to do so.

David Cameron was so impressed with the 2008 bestseller Nudge by American economists Richard Thaler and Cass Sunstein, who formulated the idea, that he instructed all his shadow cabinet to read it in opposition.

However, right wing elements of the Conservative Party object to what they believe is a nanny state lurking in what advocates term “liberal paternalism”. Lansley said that public health policy would be guided by a “ladder of intervention”, with persuasion used for certain policy objectives – such as increasing walking to school – and regulation for others.

For example, another idea to be put forward in the white paper is that cigarettes should only be sold in plain cartons, with tobacco companies banned from using attractive colors and designs to sell their products.

Imperial Tobacco, which makes brands including Lambert & Butler and Gauloises, has already indicated it will fight such legislation in the courts.

Lansley said: “This ‘ladder of intervention’ will help policymakers in central and in local government to deliver a public health strategy that is geared towards promoting effective behavior change and interventions only where necessary.”


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