Is It Fair to Lay Childhood Obesity at the Schoolhouse Door?

by Bettina Elias Siegel on March 1, 2011

Last week I attended a second “Nutrition Strategy” meeting here in my Houston school district.  As I described last month, these meetings bring together a variety of stakeholders in our community — people within HISD, public policy experts, urban farmers, parents and more — to discuss HISD’s role in improving childhood nutrition and wellness.  While we’ve only just started the process, I’m feeling optimistic that real change could come out of these discussions.

At one point in the last meeting, we honed the team’s nutrition and wellness mission statement and then discussed how we should go about measuring our eventual success in carrying out our mission.  The discussion quickly turned to using students’ BMI data, information which is routinely collected at all of our schools.  At this point, though, I interrupted.  What I said, in essence, was that it would be fantastic if HISD’s health and wellness efforts could show an actual reduction in overall student obesity — indeed, our Food Services Director would probably find himself on the national news if we could pull that off — but obesity is such a multifaceted problem that it seemed unlikely that we could  actually show a measurable effect from the schools alone.  (The group agreed with me, although we will certainly still look at student BMI data and hope to see a change for the better.)

That’s why I was glad to read writer/blogger Jane Black’s entry in Slate magazine’s crowd-sourcing effort to combat childhood obesity.  Entitled “School Lunch is Not the Answer,” Black lays out very effectively the reasons why this is so:

. . .  parents are the real shapers of children’s eating habits; kids learn what to eat at home. Frequent, sit-down, home-cooked family meals—with the television off and parents and children engaged in conversation about the day’s events, the food, etc.—are key to developing a healthy lifestyle. . . . On the flipside, parents who follow marketers’ cues and serve “kids’ food” (such as Dora the Explorer yogurt and all varieties of chicken nuggets) raise children who may be resistant to trying new foods that are not as intrinsically appealing as the high-sugar, high-fat alternatives they’ve been weaned on.

Schools can only do so much to compete with the $10 billion annual bombardment of food advertising and the steady diet of burgers, fries, pizza, and chicken nuggets those ads are pushing. Moreover, to make their numbers, schools must serve food that the kids—their customers—are willing to pay for.

I encourage you to read the rest of Jane’s entry, which also discusses the pragmatic reasons why school food became the focus of the Obama administration and other anti-obesity activists, even if improving school food is not going to be a panacea in the obesity battle.

Meanwhile, don’t forget that YOU have a voice in the Slate crowd-sourcing effort, too.  As I described last week, this “Hive” is open to all, so stop by Slate and leave an entry if you have something to say.

[Hat tip to Chef Ann Cooper for alerting me to Jane Black's entry.]

[Ed Update:  One of the hazards of my habit of blogging at 6:30am, before my morning coffee (sort like blogger "drunk dialing") is that I don't always fully flesh out my thoughts before hitting "publish."  And one absolutely critical point left out here  (indeed, it's so important to me that it was the subject of my very first post on TLT) is that schools are a key learning environment for children re: food and nutrition.  So even if consumption of the food itself is not resulting in a shift in obesity measures, the food is still sending kids a daily message about what constitutes sound eating (though schools often bungle that message, as when HISD serves pepperoni pizza and mashed potatoes at the same lunch).  For that reason alone, of course, we need to improve school food.  My narrower point was simply that we can't expect that simply "fixing" school food will result in a sudden disappearance of childhood obesity.]

{ 12 comments… read them below or add one }

Grace @eatdinner March 1, 2011 at 9:25 am

Childhood obesity is a multifaceted problem that needs multiple solutions at once. I think agree with Jane Black that parents are powerful in this fight and that family dinner is key (my hive proposal is at http://slate.me/dPxoAh).

I would love to see some of the energy and activism around school lunch reform turn to broader topics of helping support parents to make better food choices at home. Public policy and environment affects individual choices too! A better environment would include better access to healthy food, restrictions on advertising to children and plain old health education to help parents weed through conflicting messages in order to make the best choices.

That said, school lunch reform is still an important piece in the fight on childhood obesity since so many kids get breakfast and lunch at school. Preserving recess and play at school, creating livable streets, and restricting TV and computer are all positive ways to combat the problem. Family dinner (and the less TV) is something that parents can do on their own and get started with right away.

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Bettina Elias Siegel March 1, 2011 at 9:55 am

Grace – agree with all your points. And see my Ed. Update on the post, too.

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Renee March 1, 2011 at 2:35 pm

I think that Marion Nestle’s blog, Food Politics, does a good job of discussing how public policies actually reinforce poor food choices at the moment. There are a lot of people who say they don’t want government involved in their food choices, but don’t realize just how heavily government is already influencing our food choices through agribusiness subsidies. Public policy is really important in this fight.

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Bettina Elias Siegel March 2, 2011 at 9:26 am

Absolutely.

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Bri March 1, 2011 at 9:48 am

While you know I’m passionate about seeing real reform come to school lunches, I have to say that my passion has nothing to do, in reality, with reducing childhood obesity. Might that be a positive outcome that results from real reform? Certainly. But I think we should be trying to reform school food because it’s not currently REAL food, and therefore has terrible consequences for learning, behavior, and general health. Notice that I don’t list weight as a specific concern on that list.
The idea that a kid’s weight can be determined by their school lunch alone is laughable. Certainly a daily dose of the school fare can contribute; but it’s also true that many kids eat nothing but that type of food and do not develop a weight problem, while kids like mine never touch the stuff and still have a high BMI. Whenever I hear about schools using BMI as a measurement of their success in providing greater nutrition, I feel very conflicted.
My son will likely always have a slightly higher than average BMI, for many reasons, and diet/lack of appropriate nutrition is nowhere on that list. The idea of having to constantly hear about it not only from his pediatrician, but maybe someday from his school, gives me real pause. BMI is only one indicator, and not an entirely sound one, of health in children; and I think that using it as a measurement of good nutrition work in schools is a red herring.

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Bettina Elias Siegel March 1, 2011 at 10:01 am

Bri – Totally agree about “learning, behavior and general health!” And also see my Ed Update added after you posted this comment.

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jenna Food w/ Kid Appeal March 1, 2011 at 9:51 am

if the question is “if the nation could do only one thing, fix school food, or fix food in the home to prevent child hood obesity, which would it be” that would be a tough question. As Dr SuRu says, students who eat 2 meals at school 180 days a year over 12 or 13 years of school represents a large chunk of their meal time experiences. We can’t ignore the school food part of the equation.

I don’t think the problem can be solved just by the schools or just by parents. I think parents have to get food right at home, schools have to get food right at school, and as a nation we have to look in the mirror and really decide “are we eating junk food in moderation” like we claim we are? In a lot of cases it’s ignorance.

It is so hard to wrap your brain around a granola bar counting as junk food. It’s hard to think of blueberry crunch whole grain breakfast cereal as junk food. When most people believe folks are overweight because they eat too much saturated fat, the obesity problem won’t be fixed.

So in addition to schools and parents getting food right, the medical community has to get food right too. We need a paradigm shift of doctors willing to look at research by Dr Lustig, Harvard University’s Dr Willet and emory university’s sugar=heart disease study http://tinyurl.com/4ryvdv9.
Drs need to adopt the message “significantly reduce the amount of sugars, (including natural fructose sans fiber like honey, agave and 100% fruit juice, in your diet), eat real fat to support brain and energy needs, and consume lots of real plant based food to nourish and detox your body.”

Ever wonder why the grains we give cows to fatten them before slaughter are the same grains the food pyramid says are good for human health? humans can tolerate some grains without harm to health, but not as a primary source of calories, even as “whole” grains.

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Bettina Elias Siegel March 1, 2011 at 10:00 am

Jenna – your comment points to one reason why I have yet to submit my own “solution” to the Hive. How can I choose just one facet of this multi-faceted problem to address? As you say, it’s parents, schools, doctors– and I’d add food manufacturers, agricultural policy, the outsize influence of lobbyists. I’m sure we could keep adding to the list! Also, see my Ed Update added after you posted this comment.

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Louise Goldberg March 1, 2011 at 10:15 am

Bettina-what is this nutrition strategy committee? Can you tell me more about this and can anyone get involved in it? Is a dietitian from HISD involved?
Remember Lunchline interview with Janet Poppendieck (if I’m remembering correctly…which I may not be)–she mentioned a study that was done (by her?) where they assessed the weight of children who brought their lunch vs. those who bought from the cafeteria and they followed those children through at least one year-maybe it was all of elementary school? I can’t remember the details right now. They controlled for other variables like socioeconomic status and the weight of the children who ate school lunches had significantly increased. Don’t underestimate the impact. I, as usual, always support more nutrition education for parents and students for the home setting too, of course.

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Bettina Elias Siegel March 1, 2011 at 11:08 am

Louise: I’m aware of a study frequently cited by Poppendieck that showed that kids who ate school food did better nutritionally – i.e., were getting more nutrients/a more balanced diet – -but I don’t believe that particular study looked at obesity. Meanwhile, I reported a few weeks back on a study that found that regularly eating school food was a risk factor for obesity, but I’m not sure they controlled for socioeconomic status, which of course would be a huge oversight. As for the committee, I’ll email you offline to discuss. And thanks for that Boston Globe link – will post shortly! – Bettina

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louise Goldberg March 1, 2011 at 3:10 pm

Ok, now I’m going to have to buy the DVD and have a movie night to refresh my memory. If it wasn’t Poppendieck, it was someone else in the movie! MTF (more to follow)

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Bettina Elias Siegel March 2, 2011 at 9:26 am

It could be MY faulty memory, Louise. Let me know what you find out.

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