May 2013





New SNAP-Ed toolkit helps states identify obesity prevention strategies

May 7, 2013, NCCOR

On March 30, the U.S. Department of Agriculture (USDA) unveiled a new toolkit to help states identify evidenced-based obesity prevention policy and environmental change interventions to include in their Supplemental Nutrition Assistance Program Education (SNAP-Ed). The toolkit includes strategies and interventions that can be readily adopted by states in a variety of different capacities including child care, school, community, and family settings.

All 50 states, the District of Colombia, and the Virgin Islands provide nutrition education for participants enrolled in the Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps) and other eligible low-income individuals. The goal is to help people make healthy food choices within a limited budget and choose physically active lifestyles consistent with the current Dietary Guidelines for Americans and MyPlate.

Traditionally, the focus of SNAP education initiatives has been on the individual recipient, but the Healthy, Hunger-Free Kids Act of 2010 transformed the program into a nutrition Education and Obesity Prevention Grant Program. Known as SNAP-Ed, the program explicitly adopts obesity prevention as a major emphasis and embraces comprehensive, evidence-based strategies delivered through community-based and public health approaches.

In October 2012, USDA asked for help from the National Collaborative on Childhood Obesity Research (NCCOR) in developing a toolkit of effective and actionable tools and interventions that embody community-based and public health approaches to nutrition education and obesity prevention. NCCOR immediately convened a group of members interested in working on the project and helped USDA assemble a set of tools that are: (1) proven effective, (2) consistent with SNAP-Ed policy and practice, (3) suitable for low-income populations, and (4) likely to achieve obesity prevention goals.

The final product is an online toolkit that offers a robust group of effective interventions that can be adopted by SNAP agencies and providers at the state level. The toolkit was drawn from various sources, including public health literature, collections of existing interventions, and other resources developed by organizations including the Centers for Disease Control and Prevention (CDC) and the North Carolina Center for Training and Research Translation (Center TRT).


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Publications & Tools

Report highlights effects of USDA’s Fresh Fruit and Vegetable Program in schools

A March 2013 report from the U.S. Department of Agriculture Food and Nutrition Service’s Office of Research and Analysis explores new evaluation results of the Fresh Fruit and Vegetable Program (FFVP).

FFVP aims to increase fruit and vegetable consumption among students in the most economically challenged U.S. elementary schools by providing fresh fruits and vegetable to students outside of regular school meals.

FFVP began as a pilot program in 2002 and was converted into a nationwide program in the Food, Conservation, and Energy Act of 2008, also known as the Farm Bill (PL 110-234).

Among the findings: FFVP students consumed more fruits and vegetables than nonparticipating students (approximately 1/3 cup more per day); and FFVP students consumed more carbohydrates, beta carotene, vitamins A and C, and fiber than nonparticipating students.

To learn more about the evaluation and its findings:




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Healthy People eLearning lesson offers opportunity to learn more about childhood obesity

Healthy People eLearning, a resource from the Department of Health and Human Services, is offering a new childhood obesity lesson that explores how one community is implementing and evaluating a systems-wide approach to reduce childhood obesity. The lesson, “Defining Success in a Systems Approach: The San Diego County Childhood Obesity Initiative,” examines how San Diego County is learning to evaluate its systems approach to reduce childhood obesity and create healthier environments. The course is free and offers continuing education credits.


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USDA launches updated web tool to map food deserts

Two years ago, the U.S. Department of Agriculture (USDA) Economic Research Service (ERS) first released the Food Desert Locator, an online mapping tool that used the 2000 Census and other data sets to identify low-income census tracts in which a substantial number or share of residents face challenges in accessing the nearest supermarket or large grocery store. ERS has recently released an updated and expanded the tool and renamed it the Food Access Research Atlas.

The Food Access Research Atlas has updated estimates of food desert census tracts using 2010 census data, and offers several additional distance measures to visualize access to supermarkets. For example, in the original measure, a household was considered to be facing an access challenge if it was more than one mile from a supermarket in urban areas of the country or more than 10 miles from a supermarket in rural areas. With the updated Atlas, users can also map low-income and low-access areas using distances of one-half mile and 20 miles.

In addition to expanded data layers for distance, the updated Atlas also highlights the role of vehicle availability in mitigating the difficulties of reaching a supermarket by identifying census tracts where many households lack access to a vehicle. Knowing where people face low access to both supermarkets and vehicles can be a first step toward addressing the most acute access challenges.

Another new feature identifies census tracts where a large proportion of the population lives in dormitories, military quarters, or similar group living arrangements as defined by the Census. While individuals in these census tracts may be far from a supermarket or large grocery store, such facilities frequently provide dining facilities or food stores for their residents. Noting these census tracts may provide a more accurate picture of whether these residents truly experience difficulty accessing affordable and healthy food.


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Childhood Obesity Research & News

Schools aim to improve taste, nutrition of lunches

April 5, 2013, USA Today

By Christopher Doering

When diners at an exclusive food tasting recently noshed on sesame green beans and flame-roasted redskin potatoes, they weren’t celebrating at the area’s newest culinary hot spot.

Instead, these gourmands were huddled in a high school cafeteria sampling nearly 40 delicacies that could soon become permanent items for thousands of children who eat lunch and breakfast in this Northern Virginia school district each day.

The annual tasting show, a popular event for Prince William County officials to showcase new foods and collect input from students, parents, and school staff, has taken on added significance following new U.S. Department of Agriculture (USDA) nutrition standards approved last year. School districts must now limit the calories that students consume, phase in whole grains, gradually lower sodium levels, and offer at least one fruit or vegetable per meal, among other requirements.

Schools are working to comply with these new measures by adding more green vegetables, such as spinach and broccoli, and overhauling traditional mainstays like pizza by substituting in low fat cheese and wholegrain crust, all within a limited budget. But officials are aware their efforts to improve nutrition will ultimately fail if their finicky customers at more than 100,000 institutions nationwide refuse to eat the new offerings.

For each food item, we look and say “can we afford this, is it good for them, does it meet all the new food requirements, those kind of things, but what’s really important is are they going to buy it if we put it out there,” said Serena Suthers, director of school food and nutrition services in Prince William County, located southwest of Washington, D.C.

The challenge is to win over students such as eighth-grader Terrell Worrell who only buys school lunch once a week. Worrell, one of the students attending the tasting, said he was surprised to find that he liked many of the foods he tried, especially the buffalo chicken and sweet potato swirl. In the past, Worrell and his friends have thought that as the meals have gotten healthier, the taste has failed to keep up.

“These examples that they’re thinking of putting in the school lunches, they seem like they’re trying to make them better because they’ve noticed that us kids don’t really like what they’ve been putting out so far,” said Worrell. The 13-year-old said he would be open to buying lunch more often if some of the items he enjoyed during the tasting were on the menu when he starts high school later this year. “It depends on how this turns out,” he said.

School meal programs feed nearly 32 million children each day, according to the USDA. In Iowa, nearly 400,000 students eat lunch at school every day — about 73 percent of all kids enrolled in participating state schools. An estimated 93,000 Iowa kids also eat breakfast at school.

The new nutrition guidelines were put in place at the beginning of the 2012-13 school year, starting with changes to the lunch program, to address the childhood obesity epidemic. The U.S. Centers for Disease Control and Prevention estimates 17 percent of children and adolescents are considered obese. Since 1980, the obesity rate for this group has tripled.

The new standards require lunches each week to average from 550 to 650 calories for kids in elementary school, 600 to 700 calories for those in middle school, and 750 to 850 calories for high school students. An example of a typical elementary school lunch before the new standards had cheese pizza, canned pineapple, tater tots, and low fat chocolate milk. Today it would be replaced by whole wheat cheese pizza, baked sweet potato fries, grape tomatoes, applesauce, and low fat milk.

The new school lunch regulations have been widely criticized by students, parents, lawmakers, and administrators for being too costly and not providing enough flexibility. Opponents have argued the lunches are too small and lack enough calories for active children, especially high school students who are involved in sports and other activities.

“You could have a 70-pound freshman in high school on the same diet as a 250-pound high school football player and obviously both of them would need a different level of calories,” said Rep. Steve King, R-Iowa, a vocal critic of the new guidelines. “The school lunch program was established in order to ensure that kids had a nutritious diet so they could learn and now (USDA is) using it to put them on a diet. I think they have overreached on this substantially.”

King said limiting the number of calories students consume could backfire by leaving kids hungry and more likely to consume weight-inducing junk food when they leave school.

Across the country, the foods offered to students during breakfast and lunch vary by school district. Each year, about 15 percent to 20 percent of the funding for the programs is used by the states and school districts to purchase items — ranging from unsweetened applesauce and low sodium canned beans to lean ground beef and turkey roasts — from a list of more than 180 items offered by the USDA. The remaining 80 percent to 85 percent goes to states and schools, giving them the flexibility to buy the items they need, such as a particular food popular in their region.

School districts are left to decide their own breakfast and lunch menus, as long as they comply with federal nutrition guidelines. To come up with a list of new recipes isn’t easy, and ideas are regularly mined from both traditional and unusual places.

Suthers said the school district holds a recipe contest among the staff to come up with suggestions. Some food items are taken directly from restaurant menus and adapted for use in the school. But it’s the input from students during the school day and at tastings like this one that have the most impact on shaping the course of foods that make their way into the cafeteria.

“(Children) just love the idea of having some say,” said Suthers. “So many things in kids’ lives, they don’t get to have much say in, so they love this event where they get to come and give opinions to adults.”

Those attending the tasting at the Prince William County high school were given a one-page form to evaluate whether or not they liked the food items they tried and provide any comments. During the two-hour event, students, parents, and school staff were able to visit as many of the eight food stations as they wanted before sitting down at round tables in the cafeteria to eat. USDA officials, who were in attendance, regularly go to tasting events around the country put on by schools. They also visit cafeterias during the day to talk with kids and staff about the food and identify growing trends.

Increasingly, the foods offered by the USDA and put on the menu by schools are being shaped by what children eat and see at home. Government officials in charge of ordering and buying food for the school lunch program said as the popularity grows of Thai cuisine, intense flavors like buffalo wings, and vegetarian options, kids have started asking for the items to be served in their cafeterias, too.

In addition, as parents instill a healthier lifestyle at home, kids are expecting similar characteristics in the food they eat away from the dinner table.

“Schoolchildren are becoming very sophisticated eaters,” said Laura Walter, a USDA official in charge of reviewing the foods offered to schools through the department’s Food and Nutrition Service. Walter said sometimes they get inundated with requests from school districts for certain products. The most recent delectable surprise: frozen broccoli. “Word of mouth is spreading through the grapevine. We want this,” she said.

Items do get dropped by USDA if they get too expensive to purchase or not enough schools demand them. Batter-breaded chicken and sloppy joes are some of the most recent casualties. In their place, new items are added to the menu. Later this year, USDA is considering letting schools purchase string cheese in a single serve pack, frozen spinach, and fruit cups for grab and go lunches and breakfasts.

Casey Tran, a high school senior, said at the recent tasting the food he sampled was fresher and there were more flavors than he’s used to.

“It’s pretty good compared to the stuff we have currently. I wouldn’t throw it away,” said Tran, a 17-year-old who buys lunch every day. “I’ll eat it but it can’t compare to home cooking.”


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SPARK fires up physical activity at Annapolis elementary school

April 4, 2013, The Baltimore Sun

By Joe Burris

At Germantown Elementary School in Annapolis, Md., students receive physical education once a week. Officially, that is.

Unofficially, students are engaging in the same level of activity as their “go-outside-and-play” parents of previous generations. At recess, before classes and after school — and in some cases even during classroom instruction — youngsters are getting workouts by playing traditional games, learning new ones, and creating their own spinoff versions.

Germantown Elementary is among the first schools in the area to implement a San Diego-based physical education program called SPARK, which stresses to children the importance of physical fitness, then provides grade-level equipment and instruction to back it up.

SPARK officials said the program began in 1989 as a result of a study supported by the National Heart, Lung and Blood Institute of the National Institutes of Health and San Diego State University. The program aims to reduce childhood obesity and engage students in activity that doesn’t involve waiting a turn or being selected to a team.

SPARK officials implement the program through teacher and volunteer training.

Germantown Elementary began using the program last fall. It’s not part of the Anne Arundel County public schools’ official curriculum, but is used to supplement curriculum at Germantown. Kindergarten teacher Sara Holbrook implements the program during classroom instruction using tasks such as learning the alphabet. “We just walk around the alphabet rug while playing music,” she said, “and when the music stops, they have to tell me the letter. Midway through the year, we walk around the alphabet, and they have to tell me letter sound. And by the end of the year, they’re telling me a word that starts with that letter.

“For kids who would rather sit at recess, it really engages them,” Holbrook said. “It’s kindergarten, it’s a long day, and by the end of the day, they just want to rest and hang out with their friends. But when we have volunteers who come in and run the program, those kids who sit are running around and getting the exercise they need.”

At recess, Germantown taps volunteers to lead SPARK activities. “Our P.E. teacher follows the county curriculum, but what we look to do is extend the P.E. time,” said Walter Reap, principal at Germantown Elementary. “The students have P.E. once a week, but there are other opportunities throughout the school day for students to be moving instead of sitting in their seats for extended periods of time.”

Reap said he heard about SPARK six years ago from a kindergarten teacher at the school who thought the program could help stimulate brain activity in students through movement, and could also help address behavior problems.

“At the time, it was my first year as a principal, and I couldn’t see doing something that wasn’t mandated by the county or state,” Reap said.

Yet since implementing the program, Reap said he’s seen benefits.

“One of the big words we throw around is ‘stamina’ — how long can students attend to task,” said Reap. He said that since implementing SPARK, “I have seen students attend to tasks longer.”

Christie Lenham, a Germantown Elementary parent and Annapolis resident, is one of the parents who took part in SPARK training for volunteers last fall. Since then, she said, parents have led activities such as Germantown’s Walk to School Week before spring break.

Students who could walk to school were encouraged to do so, and those who take the bus were taken on a “SPARK tour” around the school, where volunteers set up exercise stations.

“They started with arm rotations, and then they went to the next cone and did squats,” Lenham said. “Then they went to another cone and did jumping jacks and another cone and did lunges — all before school started. When they came off the buses, they kind of looked sad. By the time they went inside after doing that, they were all thrilled.”

Lenham’s son, fourth-grader Eoin Lenham, said students play games such as tag and basketball, as well as jump rope and play with hoops. He said the SPARK activity he enjoys most is a ball-kicking game where one person stands on one side of an area and kicks a ball to a group of people standing opposite. The person who catches the ball gets to kick next.

“You get to run around a lot and play outside, usually,” Eoin said.

Reap said that one of the biggest differences he’s seen at the school since implementing the program is “the energy that it brings to school each day.

“You might not see this on any test data,” he said, “but for me, as a principal, seeing students get off the bus, running around the building, I’m thinking, ‘They’re going to start the day already excited about learning, because they just had an opportunity to be engaged in a physical activity.'”


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Parents, food service directors debate snacks sneaking into kids’ diets at school

April 15, 2013, The Washington Post

By Lynh Bui

Over the din of sixth-grade lunch hour at Takoma Park Middle School, a student put down his juice and hollered: “He’s a genius! An ice cream sandwich-sandwich!”

At the other end of the table, a 12-year-old boy who had just finished a hamburger began shoving two ice cream sandwiches stacked together into his mouth.

Popsicles and a bag of chips are as easy to buy as a salad and an apple in the cafeteria of this school in Montgomery County. School officials say the snacks are healthy, meeting strict guidelines for fat, sugar and calories. But those assurances aren’t enough for some Montgomery parents, who worry about artificial dyes, processed foods and the occasional “ice cream sandwich-sandwich” sneaking into their kids’ diets.

“It’s the basic mom question, which is, ‘Should this kid be eating this at all?’ ” said Karen Devitt, co-founder of Real Food for Kids — Montgomery.

Across the country, school lunch directors, nutritionists, and parents like Devitt are asking the same question as the U.S. Department of Agriculture (USDA) crafts new federal nutrition standards limiting sugar, fat, and sodium for school snacks and drinks. The rules would be the first update to school snack guidelines in more than 30 years and would come as first lady Michelle Obama continues to take aim at childhood obesity. About one-third of children in the United States are either overweight or obese.

The mandates will be controversial. School districts worry that changes to snack guidelines will reduce food sales that help keep cafeteria budgets balanced. They also say the rules could limit some children from eating enough calories because recent federal rules shrank the size of school meals.

Others say the proposed guidelines don’t go far enough. High-fat potato chips, candy bars and sugary sodas will be out, but flavored milks or low-fat yogurts with nearly the same sugar content as certain chocolate bars could be in.

One person’s healthy snack is junk food in the eyes of another. USDA officials say the intent of the proposed standards is not to limit popular snack items but to provide healthier options for students.

“Parents and teachers work hard to instill healthy eating habits in our kids, and this proposal will ensure they have healthy options throughout school cafeterias, vending machines and snack bars,” a USDA spokesman said.

“There’s definitely a balance to be struck there between healthfulness and keeping it appealing for kids,” said Lindsey Turner, a health psychologist and research scientist at the University of Illinois at Chicago. “I don’t think it’s an either or proposition.”

Turner co-authored a report released last year that found that nearly half of all public and private elementary school students could buy snacks in schools. Much of the food was sugary, fatty, or salty with little nutritional value.

Proponents of changes from the USDA say that easy access is exactly why the federal government should create new rules. At least 39 states and individual school systems have nutrition guidelines for snacks, but the standards vary.

“It’s all over the map,” said Jessica Donze Black, director of the Kids’ Safe and Healthful Foods Project of the Pew Charitable Trusts. “There are some states in which the majority of schools are still selling regular chips and chocolate candy, and there are states where almost none are doing that.”

A majority of middle and high schools don’t offer fruit or vegetables in snack bars or vending machines, according to a report from the Pew project.

J. Justin Wilson, a senior research analyst at the Center for Consumer Freedom, said some school guidelines are so strict that students have skirted the rules by selling candy bars and soda from out of their lockers and cars.

“The foods cannot fall below a certain minimum threshold of being palatable,” Wilson said. Otherwise, “the healthfulness of the food is lost because the kids aren’t eating.”

The proposed minimum USDA guidelines would generally require snack foods to contain fewer than 200 calories a serving, with no more than 35 percent of the calories or weight coming from sugar or fat, and less than 200 milligrams of sodium a portion. The guidelines would prohibit trans fats and require that less than 10 percent of snack calories come from saturated fats.

They would also require that snack foods be either a fruit, a vegetable, a dairy product, a protein food or a “whole-grain rich” grain product or contain at least 10 percent of the daily value of a nutrient such as calcium, potassium, or vitamin D.

The beverage guidelines would eliminate sugary soda. Students would be able to buy water, low-fat plain milk, and non-fat plain or flavored milk. Juices would also have to be 100 percent fruit or vegetable juice with portion limits.

A 2012 study published in the journal Pediatrics found that children in school systems operating under strict laws regulating the nutrition of snack foods consumed less fat, sugar, and calories and were less likely to be obese by the end of middle school. Children on average consume 30 percent to 50 percent of their calories in school.

Some school food services directors say that guidelines that are too strict could hurt their budgets. Often, the amount school systems spend on providing students with free and reduced-price meals is more than what they get reimbursed for from the federal government. Snack sales help offset that.

“The revenue generated helps our bottom line,” said Marla Caplon, director of food and nutrition services for the Montgomery school system, which serves more than 70,000 meals a day. In fiscal 2010, Montgomery schools made $6.8 million on a la carte and snack sales, about 17 percent of the district’s $40.3 million revenue collections for the department of food and nutrition services.

Montgomery and other school systems in the Washington, D.C., region have similar or stricter guidelines than those the USDA is proposing. Public schools in the District ban flavored milk with added sweeteners or artificial flavors. And at the request of parent activists, the Fairfax County school system has cut the amount of artificial dyes, preservatives, and other additives from food by 80 percent.

JoAnne Hammermaster, president of Real Food for Kids, the umbrella organization that launched in Fairfax before the Montgomery parents group formed, said it’s not about eliminating snacks from schools but finding ways to give students healthy options.

“We have a captive audience when our kids are at school,” Hammermaster said. “It’s a perfect opportunity to teach them and give them examples of how to live a healthier lifestyle.”

Hammermaster said that the USDA’s proposed snack food guidelines are a good first step but that it’s important for parents such as Devitt in Montgomery to keep pushing for higher standards.

“We offer a decent lunch program, but if pizza is still considered a vegetable by government standards, then we have to take that extra step beyond just what the USDA is saying,” Hammermaster said. “Even if the Pop-Tart has the whole grain, it’s still a Pop-Tart.”

At Takoma Park Middle School students could buy everything from low-fat yogurts, apples, and milk to gummy snacks, crispy rice treats, chips, and juice smoothies. Other schools in the district sell 100 percent fruit juices, in which an 8-ounce serving has as many calories and almost as much sugar as a 12-ounce can of Coca-Cola. The juice, however, has vitamins and other nutritional value, unlike the soda.

In the cafeteria at lunch hour, sixth-grader Austin Axenfeld’s teeth and lips were stained blue. He had just finished a berry fruit-juice slush and sat a few tables away from the boy who had the “ice cream sandwich-sandwich.”

“I usually get the green apple soda,” Axenfeld said as he finished popping gummy snacks into his mouth.

Austin’s mother, Cheryl, said she has been teaching her 12-year-old son about reading nutrition labels and the problems with eating too many sweets.

“He loves the gummy snacks,” Axenfeld said. “He thinks they’re healthy because they have the word ‘fruit’ in them.”

Despite the school system’s nutritional standards, Axenfeld said she doesn’t like that her son has access to smoothies and gummy candy at school.

She also has to take extra care to monitor the purchases he makes because Austin’s school allows parents to use an automatic debit system to buy food.

“He’s by himself with an unlimited spending account and a whole bunch of sugary food in front of him,” Axenfeld said. “Kid in a candy shop is pretty much accurate.”


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