A few weeks ago we talked here on TLT about a highly controversial anti-childhood obesity advertising campaign launched by a pediatric medical group in Georgia.  Called “Strong 4 Life,” the ads featured obese — and seemingly miserable —  children, shot in black and white.  While I agreed that the print ads used slogans that were snarky and potentially hurtful,  I felt the Strong 4 Life television ads might have some redeeming value.  But most experts criticized the entire campaign for stigmatizing childhood obesity and were worried it could backfire against the very children it was designed to help.

That’s why I was all the more interested in the anti-childhood obesity campaign produced by another medical group, Intermountain Healthcare, a Utah-based system of 22 nonprofit hospitals, 185 clinics, and around 900 physicians.  Unlike the Georgia advertisements, Intermountain’s “LiVe campaign” uses a much lighter touch, focusing less directly on obesity and instead encouraging kids to adopt healthy habits with humor and/or by appealing to their desire to be cool.

Dispensing sass instead of candy

The LiVe campaign first came to my attention a few weeks ago when I read about its “talking vending machine,” a fake machine placed in schools that sasses kids with funny messages when they try to buy the junk food inside.   (You can hear some of the messages yourself with this simulation.)  I’ve since learned that LiVe also makes use of teen flash mobs, school assembly presentations, a mobile app, educational materials for health providers, and a website with interactive games and quizzes and links to resources for parents.

Here’s just one of the cute videos produced by LiVe, most of which have aired on television in Utah as well as being available on the LiVe website.

To learn more about LiVe, I interviewed Dr. Tamara Sheffield, Intermountain’s Director for Community Health and Prevention:

TLT:  Can you tell TLT readers a little about the background of the LiVe program?  How did it start, who is behind it, etc.?

Dr. Sheffield with students at Rose Park Elementary in Salt Lake City

Dr. Sheffield:  Intermountain Healthcare launched the “LiVe” program in 2007 as a public service campaign to help kids, teens, and families be more physically active and make more healthy food choices. It was started when Intermountain doctors and nurses focused on community health teamed with our communication staff.  The program’s core messages focus on “8 Healthy Habits” which were identified by Intermountain clinicians:

1. Always eat breakfast
2. Eat more fruits and vegetables
3. Limit sweetened drinks
4. Limit screen time
5. Increase your physical activity
6. Eat meals together as a family
7. Be positive about food
8. Don’t criticize about weight.

TLT:   What have the responses to the talking vending machine been like?

Dr. Sheffield:  The vending machine is intended to help kids understand the importance of making healthy food choices in a fun and entertaining way.  We move the machines from school to school about every 3-4 weeks.  We find that after that time all the kids have had a chance to interact from it and learn from its messages. The response has been enthusiastically positive from kids, parents, and from the schools.

TLT:  How would you describe the philosophy behind the LiVe campaign — “anti-obesity?,” “pro-health?”  Something else?

Dr. Sheffield:  Our goal with the LiVe campaign is to approach the important issue of healthy eating and activity from a child’s point of view and offer positive, helpful solutions for families. The philosophy behind LiVe is that making these good choices makes you feel better now with a more rich and full life at the same time it prepares you for a better future. LiVe can help children be more physically active and make healthy food choices. By coordinating with parents, schools and the medical community, we believe we can reverse the direction of this crisis.

TLT:  What are your goals for the campaign?

Dr. Sheffield:  The aim of the LiVe program is to educate kids and parents on the 8 Healthy Habits—simple behaviors they can focus on to be more active and eat healthy.  In addition, Intermountain Healthcare offers LiVe classes and nutrition counseling for healthier living and weight management. Courses are available for children, teens, and adults. Most insurers will reimburse eligible members the registration fee upon completing the course.

* * *

Thanks to Dr. Sheffield for taking the time to be interviewed here.  While there are no efforts underway to directly measure the impact of the LiVe campaign, it seems to me that lighter approaches like this could be quite effective, especially among teens who might be otherwise hard to reach.  What are your thoughts on the LiVe campaign?

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Tomorrow I’ll be speaking before our school board in my capacity as chairperson of the food and nutrition subcommittee of the Houston ISD School Health Advisory Council (SHAC).

This will be the first time the SHAC will be addressing the board face-to-face about an issue of concern:  the often nutritionally sub-par items sold on our campuses, by outside groups and HISD itself,  that compete with the federal school meal.  As an example, here’s a picture of one high schooler’s lunch last month, provided from our district’s own a la carte menu —  fried chip nachos and a red and blue juice slushie:

You can read more about the upcoming meeting on today’s Spork Report.

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Those of us with kids who are, to put it mildly, a tad veggie-resistant often scratch our heads and wonder where we went wrong.

In my own case, I’ve long been baffled by my son’s (now lessening, but still an issue) vegetable avoidance, given that we’re clearly doing a lot right. For example, my husband and I love vegetables and have modeled our enjoyment of them since my son’s birth. Following what I believe is sound advice, I’ve tried (when humanly possible) not to make too big a deal out of it, lest our pressure backfire. In keeping with the notion that kids eat what they grow, my son has had the experience in school of growing his own vegetables — but nonetheless passes on a chance to taste the harvest. And, not to be immodest here, but I’m a pretty decent cook and my vegetable side dishes are, in general, tasty and kid-accessible.

So where did I go wrong? Turns out the problem is quite simple: I’m not French.

Just havin' fun with the stock photo credits, people. TLT does not in any way endorse the dyeing of one's tomatoes blue just to make a cool French veggie montage.

OK, I’m being a little glib here, no doubt because I’m feeling pretty bitter. Go check out Dina Rose’s fascinating post today on It’s Not About Nutrition, discussing why French kids may be eating more vegetables than your kids do, and what we can all learn from the differences between how the French and the Germans approach early childhood feeding. It’s such an interesting read.

And as for my son and the ways in which I may have failed him as an infant? Well, what can I say now except “C’est la vie?”

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After grappling last week with the weighty issue of new USDA school food nutrition standards, let’s ease into our Monday with something a little fluffier, shall we?

Allow me to present The Great American Cereal Book, billed by Amazon as “the definitive compendium of breakfast cereal history and lore.”  Co-written by Marty Gitlin and Topher Ellis (more on him in a minute), this new book provides photos and short entries on hundreds of brands, from the long-enduring Cheerios to the deservedly short-lived Mr. T cereal, spanning the period between 1863 and 2010.

Here are a few photos from the book — depending on your age, they might jog a few memories:

(By the way, if you click on the picture of Quake you’ll see that the box actually describes its contents as “sugary cereal.”  How hilarious is that?  No manufacturer would ever be so honest today.)

Topher Ellis, it turns out, is “a cereal expert and editor of the cereal newsletter the Boxtop, the longest continuously running publication dedicated to breakfast cereal.”   Now see?  I just love that.  Maybe it takes one obsessive mind (um, daily blogging?) to appreciate another, but where would we be without people like Ellis, so passionate about their idiosyncratic interests that they’re willing to take the time to catalogue and share them with the rest of us?

All of this retro cereal talk makes me want to get back in my PJ’s and curl up with a sugary bowl in front of Boris and Natasha or Josie and the Pussycats.

And if you’re too young to know what I’m talking about, kindly keep that fact to yourself.

 [Ed Correction:  An earlier version of this post erroneously attributed the editorship of the Boxtop to Mr. Gitlin, not Mr. Ellis.]

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Yesterday First Lady Michelle Obama, accompanied by Agriculture Secretary Tom Vilsack, released the final federal nutrition standards for school meals, representing the first major overhaul of school food requirements in over 15 years.

As with most products of the legislative process, the end result is messy and flawed but not without redeeming value.  Here’s my bullet point summary of the best and worst aspects of the new regulations:

THE GOOD

While you may read a lot of carping in the blogosphere about where the new regulations fall short — they still allow chocolate milk, for example, which displeases those who oppose the beverage, and pizza is still a vegetable (more on that below) —  in reality there is much to be happy about.  Here are the positive highlights:

Abolition of “Nutrient Standard Menu Planning”  

This is a wonky, in-the-weeds aspect of the new regulations that you’ll likely hear little about in the mainstream press, but from my perspective it might be the single most important improvement to school meals.

Here’s the background.  Under prior regulations, schools could choose to meet USDA nutritional requirements using either a “food based” or a “nutrient standard” approach to their menu planning.  The former method is pretty much what it sounds like: districts had to serve a certain number of items from the basic food groups (breads and cereals, fruits and vegetables, meats and meat substitutes, etc.), the same way most humans approach the task of putting together a balanced meal.

But under the “nutrient standard” system (used by my own school district, Houston ISD, and many others), districts could focus instead only on whether individual nutrient requirements were being satisfied, regardless of where those nutrients came from.  This myopic, “nutritionism” approach led to some truly bizarre results, like the regular inclusion of animal crackers (aka, cookies) in our school breakfast program, added to meet the USDA iron requirement via their fortified white flour.  (My discovery of this particular practice — and my resulting confusion and anger about it — is actually what led me to start this blog in the first place.)

Despite the fact that “some school advocacy organizations, trade associations, food manufacturers, nutritionists, and other commenters suggested that NSMP [Nutrient Standard Menu Planning] be allowed as an option,” (and, by the way, is it any surprise that food manufacturers loved this approach?), USDA did the right thing and abolished it for good.

Sensible Caloric Requirements

The National School Lunch Program was started at a time when childhood malnutrition, not obesity, was the concern du jour.  As a result, for decades districts have struggled to meet calorie minimums (you read that right – minimums) while not exceeding limits on fat.  The result was the inclusion of lots of sugar in school meals, often in the form of multiple-times-a-week, or even daily, desserts and sometimes sugary beverages.

For example, someone in HISD told me informally that one motivation for serving this bright blue and red concoction at our high schools is to help meet the old federal caloric requirements:

Liquid calories.

The new regulations bring caloric requirements down, a common sense move in an age of childhood obesity.

Improved Nutrition

And now for the purely nutritional improvements you’ve probably already read about:  schools are going to be required to offer students fruits and vegetables every day, including a wider variety of produce that includes yellow and green leafy vegetables; the amount of whole-grain-rich foods will be increased; only fat-free or low-fat milk will be offered; and the rules reflect an increased focus on reducing saturated fat, trans fat and sodium.

THE BAD

So, what’s wrong with requiring schools to provide better, healthier food?  Nothing.  But what is bad is that these regulations are an unfunded mandate;  the Congressional funding increase provided to school districts – a mere six cents more per free meal — is woefully inadequate to pay for the better food.  (For more on the funding issue, check out school food reformer Dana Woldow‘s excellent piece on how the new nutrition requirements will effectively force many districts, especially those in which labor and food costs are high, to start (or continue) dipping into classroom funds to pay for school meals.)   While other countries pay far more for their school food programs — no doubt recognizing the long term benefits of such an investment — the United States continues to lag woefully behind in this regard.

THE UGLY  

As these regulations were hammered out, nothing was more disheartening than watching as our elected representatives — from both parties, by the way —  cave in like cheap suitcases in the face of Big Food’s lobbying efforts.

The USDA, at the behest of Congress, sought recommendations from the Institute of Medicine on how to bring school food standards into alignment with the Dietary Guidelines for Americans.  But after the IOM recommendations were released, Congress backpedalled furiously when the food industry asked it to.  So when potato growers objected to limits on servings of starchy vegetables, that idea was tossed.  And frozen food manufacturers, long benefitting from a quirk in the old rules that treated pizza as a “vegetable” (due to its tomato paste), fought successfully to maintain this counterintuitive status quo.

For those of us who care deeply about kids and nutrition, episodes like these were ugly indeed.

THE BOTTOM LINE

Are the new school food standards ideal?  No.  Are districts being given enough money to really get the job done?  No, again.  But do we have some cause for celebration?  Absolutely.  Initial, positive reactions from several leading nutrition advocates are here, and I’ll share with you more responses, positive and negative, as they come in.

 [Ed Update:  TLT Reader Casey Legler Hinds shared with me on TLT's Facebook page this excellent USDA chart which allows a quick comparison of the old and new rules.  Thanks Casey!]

Do You Love The Lunch Tray? ♥♥♥ Then “like” The Lunch Tray! Join over 1,550 TLT fans by liking TLT’s Facebook page (or follow on Twitter) and you’ll get your Lunch delivered fresh daily, along with bonus commentary, interesting kid-and-food links, and stimulating discussion with other readers. You can also check out my virtual bulletin boards on Pinterest and find selected TLT posts on The Huffington Post.

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Mrs. Q, aka Sarah Wu

If you’re a reader of this blog you probably already know all about Mrs. Q, the (formerly) anonymous public school teacher who set about the unenviable task of eating the same school food her students were eating for an entire year.  Her photographs of that food and her accompanying blog, Fed Up with Lunch, provided an eye-opening expose of the kinds of meals served to millions of American schoolchildren in lunch rooms around the country:  mysterious, shrink-wrapped entrees, fried chicken patties, the ubiquitous square pizza and highly processed PBJ “sandwiches” that crumbled to the touch.  Mrs. Q wound up writing a book about her experiences and late last year she finally revealed her true identity on national television:  she is Sarah Wu, a bilingual speech pathologist in Chicago.

Sarah’s book, also titled Fed Up With Lunch, is as much a personal memoir as it is a book about school food reform.  We follow her as the unexpected success of her blog pushes her out of her comfort zone.  Soon she’s doing interviews, speaking in public and adjusting to the new role of school food “expert,” all while struggling to keep her identity secret from her co-workers.  We also see her consciousness about food slowly evolve, as she draws connections between her toddler’s frequent illnesses and his diet, and as she becomes more interested in the origin of the food she eats, both in school and at home.  Meanwhile, her husband, who never before showed much interest in food preparation, begins to grow his own herbs and vegetables and learns to cook.

It’s an entertaining journey told with humility and humor, and made even more interesting by the many little “sidebars” sprinkled throughout the book covering everything from salad bars to recess to hormones in milk.  The book concludes with “Mrs. Q’s Guide to Quiet Revolution:  An Action and Resource Guide” which provides advice for different stakeholders – parents, teachers, kids, teenagers, chefs and nutritionists – as well as a Resources Guide to point would-be school food reformers toward helpful organizations, blogs and reading material.

Anyone curious about the current state of school food and how to improve it will want to pick up Fed Up With Lunch.  And, thanks to Sarah’s generosity, one lucky Lunch Tray reader has a chance to win a free copy!  Just leave any comment below by noon CST tomorrow (January 26th) to enter the drawing.  You can tell us about the school food in your area, talk about Sarah’s blog, or  just say hi.  I’ll use a random number generator after the comment period closes to select one lucky winner, and if you comment twice (e.g., to respond to something another reader wrote), that’s fine;  I’ll just use the number of your first comment to enter you in the drawing.   I’ll email you directly if you win and announce the winner on TLT’s Facebook page, too.

Good luck!  :-)

[Blogger disclosure:  As with most of my book reviews, I received a free copy of this book for my perusal.  However, I never accept any other form of compensation for the book reviews you see on The Lunch Tray.]

Do You Love The Lunch Tray? ♥♥♥ Then “like” The Lunch Tray! Join over 1,550 TLT fans by liking TLT’s Facebook page (or follow on Twitter) and you’ll get your Lunch delivered fresh daily, along with bonus commentary, interesting kid-and-food links, and stimulating discussion with other readers. You can also check out my virtual bulletin boards on Pinterest and find selected TLT posts on The Huffington Post.

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As I mentioned yesterday, later this morning First Lady Michelle Obama and Agriculture Secretary Vilsack will announce the USDA’s long-awaited, new school food nutrition standards.  The event will take place at Parklawn Elementary School in Alexandria, VA, a HealthierUS Schools Challenge award winner, and attendees will be treated to a healthy school lunch prepared by Rachel Ray.

I’ll share my thoughts on the new standards in the coming days.  For more on today’s event, visit Obamafoodorama.

Do You Love The Lunch Tray? ♥♥♥ Then “like” The Lunch Tray! Join over 1,550 TLT fans by liking TLT’s Facebook page (or follow on Twitter) and you’ll get your Lunch delivered fresh daily, along with bonus commentary, interesting kid-and-food links, and stimulating discussion with other readers. You can also check out my virtual bulletin boards on Pinterest and find selected TLT posts on The Huffington Post.

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On today’s Spork Report, I discuss intensive school food audit going on in my district this week.  While a USDA and state “Coordinated Review Effort” is routine, it’s also a big deal and the district has been working hard for months to prepare for it.

Also, as I mention in the post, tomorrow First Lady Michelle Obama and Agriculture Secretary Tom Vilsack will be announcing the long-awaited new school food nutritional standards promulgated as part of the passage of the Healthy, Hunger-Free Kids Act of 2010.  I’ll be talking about those new standards here in the coming days.

Do You Love The Lunch Tray? ♥♥♥ Then “like” The Lunch Tray! Join over 1,500 TLT fans by liking TLT’s Facebook page (or follow on Twitter) and you’ll get your Lunch delivered fresh daily, along with bonus commentary, interesting kid-and-food links, and stimulating discussion with other readers. You can also check out my virtual bulletin boards on Pinterest and find selected TLT posts on The Huffington Post.

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Gong Hey Fat Choy, people, or Happy Chinese Lunar New Year!*

To celebrate the Year of the Dragon today, I wanted to share with you two books – one for kids, one for grown-ups — by cookbook author Nina Simonds.

If you’re not familiar with Nina, she’s a leading Asian food expert and award-winning journalist whose writing has appeared in countless publications such as Gourmet, the New York Times, Bon Appetit and O magazine.  She’s the author of ten books on Chinese cuisine and culture, including A Spoonful of Ginger which has been on my cookbook shelf for years.  And now and then she’s even come by TLT  to leave a comment [blogger swoon].

A few years ago, Nina co-authored a children’s book called Moonbeams, Dumplings and Dragon Boats.  Organized around four Chinese festivals — Chinese New Year and the Lantern Festival; Qing Ming and the Cold Foods Festival; the Dragon Boat Festival; and the Mid-Autumn Moon Festival — the book offers activities, games, stories and recipes for each.  For example, when learning about Chinese New Year, young readers can enjoy “The Story of the Kitchen God,” write good luck characters on red paper, create their own paper lanterns and then head into the kitchen with you to make New Year Dumplings.  It’s a lovely book worth checking out if you’d like to expose your kids to and/or celebrate Chinese culture.

And now I want to offer my grown-up readers a chance to win an autographed copy of Nina’s beautiful new Asian cookbook, released just this month.  Simple Asian Meals has recipes for Hearty Soup Pots, Stir Fry Suppers, Main Dish Salads, Sumptuous Vegetarian Fare,  Irresistible Sweets and more.  And true to its subtitle – ”Irresistibly Satisfying and Healthy Dishes for the Busy Cook” — these are not intricate recipes you have to labor over all day.  Rather, Nina has pared the ingredient lists down to their essentials and even encourages you to take advantage of short cuts like pre-cut butternut squash or packaged fresh green beans.  Delicious, healthful Asian meals that are totally do-able on a weeknight – hooray!

For a chance to win the autographed copy of Simple Asian Meals, leave a comment below before noon CST tomorrow, January 24th.  You can share your favorite Asian recipe, tell us why you’d like to win the book, or just say hi.  I’ll use a random number generator after the comment period closes to select one lucky winner, and if you comment twice (e.g., to respond to something another reader wrote), that’s fine;  I’ll just use the number of your first comment to enter you in the drawing.   I’ll email you directly if you win and announce the winner on TLT’s Facebook page, too.

Good luck!  Or, according to Google Translate,  好运 !    

 [Blogger disclosure:  As with most of my book reviews, I received a free copy of these two books for my perusal.  However, I never accept any other form of compensation for book reviews on The Lunch Tray.]

[*Ed. Update:  Several readers have reminded me this morning that today is not just Chinese New Year but the Lunar New Year, celebrated by many Asian cultures.  Noted and corrected!  But unfortunately I think I can't change the title of the post without causing Google havoc.] 

Do You Love The Lunch Tray? ♥♥♥ Then “like” The Lunch Tray! Join over 1,500 TLT fans by liking TLT’s Facebook page (or follow on Twitter) and you’ll get your Lunch delivered fresh daily, along with bonus commentary, interesting kid-and-food links, and stimulating discussion with other readers.  You can also check out my virtual bulletin boards on Pinterest and find selected TLT posts on The Huffington Post.

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Last month a Brooklyn nine-year-old named Jonathan Jewth tragically choked to death while eating meatballs in his school cafeteria.  The New York Post, which first broke the story, reported that the lunchroom workers on duty at the time were unable to assist the boy.  Said an eyewitness quoted in the Post:

The only thing the lunch ladies did was go up to the boy on the floor and yell at him to put his own fingers down his throat. He had been unconscious already for a while. . . . Nobody was paying attention and they didn’t know how to give aid, nobody knew what to do.

This episode, while undeniably horrific, struck me as a highly unlikely occurrence.  But then I started thinking about the typical elementary school lunch room:  children talking, laughing, shouting and sometimes playfully shoving each other as they eat.  I also considered the fact that higher-risk foods like carrot sticks, hot dogs and grapes are commonly found in kids’ lunches, and that, thanks to No Child Left Behind, public school lunch periods are shorter than ever, with some children getting as little as fifteen minutes to scarf down their entire meal.

I did some investigating and was surprised to learn that during the very same month Jonathan Jewth died from choking, two other children (coincidentally also in New York state) were reported to have choked on food in school lunch rooms.  These children, however, were fortunate in having an adult nearby who (a) recognized that they were in distress and (b) were trained in performing the Heimlich maneuver.   (Nine-year-old Hannah Goldberg, just like Jonathan Jewth, choked on a meatball and was saved by an English teacher who had learned the Heimlich in a first aid course; twelve-year-old Nirvana Blake choked on a breadstick and was rescued by a teacher’s aide trained in the technique.)

While I was unable to find any statistics on choking on school grounds per se, the American Academy of Pediatrics reported last year that “[c]hoking on food causes the death of approximately 1 child every 5 days in the United States,” and some of the characteristics of the typical school cafeteria eating experience were identified in the report as enhancing the risk of choking:

Behavioral factors may also affect a child’s risk for choking. High activity levels while eating, such as walking or running, talking, laughing, and eating quickly, may increase a child’s risk of choking.

Indeed, I learned of one Rhode Island school that several years ago actually experienced three choking incidents in a single month, leading the school to adopt a controversial “no talking” policy in the cafeteria.  I also found numerous other media reports documenting cases of children who were rescued from choking in the lunch room by heroic fellow students who had seen or read about the Heimlich.  (A Houston-area fourth-grader who saved a girl choking on a Cheeto reported that “other students thought the girl was just laughing,” showing just how easily this incident could have turned into tragedy.)

When I asked my own school district, Houston ISD (the nation’s seventh largest), how it prepares for possible choking in the cafeteria, I was told by a spokesperson that “posters that provide instructions on how to administer the Heimlich maneuver are displayed in every cafeteria. In addition, physical education teachers are trained in CPR and first aid techniques.”  But physical education teachers aren’t required by the district to be present in the cafeteria during meals, and it’s unlikely that many actually are there on a regular basis.

My district is certainly not alone in relying on posters as the sole means of providing choking first aid — a multi-state survey conducted in 2004 found this to be the standard requirement in the vast majority of those states addressing the issue in their statutes regulating food service establishments.  But even professional chefs who are required to post a Heimlich illustration in their restaurants don’t always know how to actually employ the technique in an emergency.  Cookbook author Joan Nathan recounted in the New York Times how she once choked on a piece of chicken in a room full of well-known chefs, some of whom later admitted they were unsure of how to help.  (Fortunately, celebrity chef Tom Colicchio knew what to do.)  And while the media reports I found were silent on the point, it’s very likely that the Brooklyn school food service workers in the Jonathan Jeweth case were standing in close proximity to just such a poster, which is legally required to be prominently placed in all New York food service establishments.

It’s notable, then, that the American Academy of Pediatrics recommends that choking first aid for children actually “be taught to parents, teachers, child care providers and others who care for children.”  In the specific context of schools, I was able to find one state, Ohio, which has made it mandatory for an adult trained in choking first aid to be in attendance in the cafeteria while meals are served, and the state of Virginia passed legislation over a decade ago “encouraging” the same practice.

Of course, we can’t prevent every conceivable tragedy that might strike our kids at school, and taking extreme or costly measures to ward off unlikely occurrences isn’t justified.  But in the case of a choking, physically demonstrating the Heimlich maneuver to school food service workers as part of their regular training hardly seems burdensome.

And as the Jeweth case sadly demonstrates, those few minutes of extra training could easily save a child’s life.

[This post also appears in The Huffington Post.]

Do You Love The Lunch Tray? ♥♥♥ Then “like” The Lunch Tray! Join over 1,500 TLT fans by liking TLT’s Facebook page (or follow on Twitter) and you’ll get your Lunch delivered fresh daily, along with bonus commentary, interesting kid-and-food links, and stimulating discussion with other readers.

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