Nutrition Guidelines Help Childhood Obesity What If School Foods Improve and Kids Are Still Fat? Opinion By KEITH-THOMAS AYOOB April 26, 2007 —
The Institute of Medicine came out with its recommendations for the types of foods to be served and sold in schools, and it really hit home -- or did it?
The guidelines were spurred by the epidemic of childhood obesity, and they're much stricter than ever before. Not only do foods have to be good for you and nutrient-rich, they also have to be "not bad" for you. The institute developed a two-tier formula that involves types of foods and grade level.
Tier 1 foods are the free-for-alls: They can be sold at anytime during the school day because they contain foods we want kids to eat more of: fruits, vegetables, whole grains and low-fat dairy foods.
The foods served can't have more than 200 calories per serving, and they must supply at least one serving of any of these food groups, be low in fat, saturated fat, sodium, added sugars and have no added caffeine.
Bravo for the limit on added caffeine. The soda companies are not pleased, but then, carbonated beverages are not a part of Tier 1 foods anyway.
Tier 2 foods would be only for high schools and after school, so things are slightly more liberal. Tier 2 foods don't have to contain a whole serving of the above food groups, but they have to keep to the same limits for total fat, saturated fat, added sugars, caffeine and sodium.
Now, carbonated beverages are allowed, but sugared sodas are not. Beverages can't have more than five calories per serving, which limits them to water and diet soda. Even then, soda companies couldn't dump a mini multivitamin-mineral supplement into the drinks so that they'd look nutritious, either. Not allowed by the institute. Sugar substitutes, however, are allowed. Relax -- truth is, they're perfectly safe.
All this is great. As a pediatric nutritionist, how could I object? I don't. I'm ecstatic.
Foodwise, things in our schools are beginning to look up. If we could get physical education back into the curriculum -- grades 1 through 12, thank you -- then the schools would very much be doing right by the students.
Fighting Fat on the Home Front
But anyone who thinks the school food reform will solve the problem of childhood obesity is sadly mistaken.
Kids are in school only six hours a day. The school breakfast and lunch are set and calorie-controlled. Now, possibly the other foods sold in schools will be as well.
But there's a dirty little secret about the obesity epidemic that no one wants to think about
: what goes on at home.
The obesity epidemic will continue until we address what's happening during the
other 18 hours of the day when kids are not in school. That's when kids get the bulk of their calories.
After school and at dinner, kids are no longer products of the school system. Rather, they're heavily influenced by the eating environment at home, and what's available.
Worse yet, older kids are beholden only to the amount of money they have to spend. Parents may complain that their 12-year-old "just buys junk food after school," but they still give him money every day.
Maybe the report on foods sold in schools should be a wake-up call -- not just for schools or food companies, but for parents as well. This may be less a burden, however, and more an opportunity for parents and families.
All parents want the very best for their kids in every way. They move to a neighborhood with the best school district. They want the best teachers. They drive across town to the best music or karate lessons.
And of course they want their kids to have the best food a school can offer.
Perhaps now it's time to take a look in the mirror and assess what can be done on the home front to give our kids the best.
Tips for a Trimmer Kid
The good news is that things don't need to change radically all at once. Just a little at a time, but the time to start is now.
Here are just a few tips to create an eating environment at home that has many of the same positive characteristics as the schools may soon have:
Push the positives: Have kids' favorite fruits and veggies around as anytime snacks. It's a win-win. All kids have a few favorites. Start with those.
Juice is OK, but keep portions small. Dilute 4 oz. with an equal amount of cold water so you have 8 oz. of a lighter beverage.
Got cookies and sweets around? Keep 'em to a minimum. Just one type, no smorgasbord here. Try having just oatmeal cookies or just graham crackers. That way kids will be more interested in the huge bowl of summer fruits instead.
Keep dairy foods to low-fat and fat-free milk and yogurt, but lighten up about chocolate milk. If it's low-fat or fat-free, it's OK. No need to be overly vigilant here -- and besides, it's still a nutrient-rich drink.
Be a good role model. Kids watch what you do, so do the right thing, especially in front of them.
Keith-Thomas Ayoob is an associate professor in the department of pediatrics at the Albert Einstein College of Medicine in New York City. Childhood Obesity 
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