Transcript Document

National Nutrition
Standards In the Schools
School Nutrition AssociationUSDA State Agency Conference
November 27, 2007
Virginia A Stallings, MD
Children’s Hospital of Philadelphia
University of Pennsylvania
School of Medicine
The most pressing challenge to nutritional health in this first
decade of the 21st century is obesity.
Competitive Foods are Widely
Available in Schools
Percentage of Schools Offering Competitive Foods
Food Venue
A la carte
Snack Bars
School-Related Health Policy
• 2004 Child Nutrition and WIC
Reauthorization Act
• Wellness Policy Required by 2006
– Nutrition education goals
– Physical activity goals
– Nutrition guidelines
– Other school-based activities
Nutrition Guidelines
• All foods available on campus with
objective of promoting health and
reducing obesity
• FY 2005 Congress directed CDC to
initiate an IOM study to review the
evidence and make recommendations
Institute of Medicine
• National Academies chartered in 1863 to
advise the government on scientific and
technical matters
• National Research Council, 1916
National Academy of Engineering, 1964
Institute of Medicine, 1970
• IOM for evidence-based info to support
policies related to the health of the public
Committee’s Task
• Review evidence and make nutrition
standard recommendations:
– for availability of sale, content and
consumption of foods and beverages
at schools;
– with attention to foods and beverages in
competition with federally reimbursable
meals and snacks.
• Consider lessons learned
– National School Lunch and Breakfast
– State- and local-based standards
• One standard for all ages, or not?
• Develop standards based upon
nutrition and health science
• Ensure that foods and beverages
offered in schools contribute to an
overall healthful environment
• Develop benchmarks to guide
evaluations of the standards
Committee on Nutrition Standards for Foods in Schools
• Virginia A. Stallings (chair)
Children’s Hospital of Philadelphia, PA
• Dennis M. Bier
Baylor College of Medicine, TX
• Margie Tudor Bradford,
Bardstown Independent School Dist., KY
• Carlos A. Camargo, Jr.
Massachusetts General Hospital, MA
• Isobel R. Contento
Columbia University, NY
• Thomas H. Cook
Vanderbilt University, TN
• Eric A. Decker
Univ. of Massachusetts, Amherst, MA
• Rosemary Dederichs
Minneapolis Public School District, MN
Jay T. Engeln
National Association of Secondary
School Principals, VA
Barbara N. Fish
West Virginia Board of Educ., WV
Tracy A. Fox
Food, Nutrition & Policy Consultants, VA
James C. Ohls
Mathematica Policy Research Inc., NJ
Lynn Parker
Food, Research, and Action Center,
Washington, DC
David L. Pelletier
Cornell University, NY
Mary T. Story
University of Minnesota, MN
Institute of Medicine Staff
Ann Yaktine, Study Director (from July, 2006)
Janice Rice Okita, Study Director (until July, 2006)
Amin Akhlaghi, Research Associate (until Oct., 2006)
Alice Vorosmarti, Research Associate
Heather Del Valle, Senior Program Assistant
Process and Approach
• Ten Guiding Principles
• Tier 1: All students all day “F, V, WG, D”
Tier 2: High school students after school
• Includes recommendations for:
– Non-nutritive sweeteners
– Caffeine
– Water availability
– Sport drinks
– Food for student reward and punishment
– Fund raising
The Guiding Principles
The committee recognizes that:
1. The present and future health and well-being of
school-age children are profoundly affected by
dietary intake and the maintenance of a healthy
2. Schools contribute to current and life-long health
and dietary patterns and are uniquely positioned
to model and reinforce healthful eating behaviors
in partnership with parents, teachers, and the
broader community.
3. Because all foods and beverages available
on the school campus represent significant
caloric intake, they should be designed to
meet nutritional standards.
4. Foods and beverages have health effects
beyond those related to vitamins, minerals,
and other known individual components.
5. Implementation of nutrition standards for
foods and beverages offered in schools will
likely require clear policies; technical and
financial support; a monitoring, enforcement,
and evaluation program; and new food and
beverage products.
The committee intends that:
6. The federally reimbursable school nutrition
programs will be the primary source of foods
and beverages offered at school.
7. All foods and beverages offered on the
school campus will contribute to an overall
healthful eating environment.
8. Nutrition standards will be established for
foods and beverages offered outside the
federally reimbursable school nutrition
9. The recommended nutrition standards will be
based on the Dietary Guidelines for Americans,
with consideration given to other relevant
science-based resources.
10. The nutrition standards will apply to foods
and beverages offered to all school-age children
(generally ages 4 through 18 yrs) with
consideration given to the developmental
differences between children in elementary,
middle, and high schools.
Weight management
Physical activity
Food groups to
Sodium, potassium
Alcoholic beverages
Food safety
U.S. Department of Health and Human Services
U.S. Department of Agriculture
Dietary Intake Data
Are children’s diets meeting the
Dietary Guidelines for Americans?
• <2% meet the Food Guide Pyramid
• 16% did not meet any of the Pyramid
food group recommendations
• Too few fruits, vegetables, whole grains;
not enough fiber- or calcium-rich foods
• Too much fat, sodium, added sugar
Tier 1 for All Students All School Day: Foods
Tier 1 foods are fruits, vegetables, whole grains, and
related combination products and nonfat and low-fat
dairy that are limited to 200 calories or less per portion
as packaged and:
 No more than 35% of total calories from fat
 Less than 10% of total calories from saturated fats
 Zero trans fat (≤0.5 g per serving)
 35% or less of calories from total sugars, except for
yogurt w/ no more than 30 g of total sugars, per 8-oz.
portion as packaged
 Sodium content of 200 mg or less per portion as
Tier 1 for All Students: Foods
Á la carte entrée items meet fat and sugar limits
as listed above and:
o are National School Lunch Program (NSLP)
menu items
o have a sodium content of 480 mg or less
Tier 1 for All Students All School Day: Beverages
Tier 1 beverages are:
 Water without flavoring, additives, or carbonation.
 Low-fat (1%) and nonfat milk (in 8 oz. portions):
o Lactose-free and soy beverages are included
o Flavored milk with no more than 22 g of total sugars
per 8-oz. serving
 100-percent fruit juice in 4-oz. portion for elementary/
middle school and 8 oz. for high school.
 Caffeine-free, with the exception of trace amounts of
naturally occurring caffeine substances
Individual fruits: apples, pears, fruit cups packed in juice
Vegetables - baby carrots
Dried or dehydrated fruit - raisins, apricots, apples
100 percent fruit juice or low-salt vegetable juice
Low-fat, low-salt whole-grain crackers or chips
Whole-grain, low-sugar cereals
100 percent whole-grain mini bagels
Whole grain granola bars w/ or w/out fruit (Total = 1 serving)
4, 6, or 8-oz low-fat fruit-flavored yogurt with no more than
15, 22.5, or 30 gm sugar accordingly
• 4, 6, or 8-ounce servings low-fat chocolate milk with no more
than 11, 16.5 or 22 gm sugar accordingly
Tier 1 Foods and Beverages
Tier 2 for High School Students After School
Tier 2 beverages are:
Tier 2 snack foods are:
those that do not exceed
Non-caffeinated, non200 calories per portion as
fortified beverages with
packaged and:
less than 5 calories per
 No more than 35% of
portion as packaged:
total calories from fat
with or without:
<10% of total calories
- nonnutritive sweeteners,
from saturated fats
- carbonation,
 Zero trans fat
- flavoring
(≤0.5 g/portion)
 35% or less of calories from
total sugars
 Sodium content, 200 mg or
less per portion as packaged
Tier 2 Foods and Beverages
• Low-salt baked potato chips, crackers,
and pretzels
• Animal crackers with no more than 35%
of calories from sugar
• Graham crackers with no more than
35% of calories from sugar
• Caffeine-free, calorie-free, non-fortified
soft drinks
• Frozen ice cream products that meet
the standards for sugar and fat
• Potato chips and pretzels with too much fat or sodium
Do Not
• Items
too much
or sodium
• Breakfast or granola bars with too much fat or sugar
• Ice cream products with too much fat
• Cake, cupcakes, cookies with too much sugar or salt
• Fortified sports drinks or fortified water
• Gum, licorice, candy
• Fruit smoothies with too much added sugar
• Regular colas or sodas with sugar or caffeine
Nutritive Food and Beverages
Fat: < 35/10 / 0
Total sugars < 35% kcal
<200 kcal/portion
<200 mg sodium/portion
Non-nutritive Food and Beverages
5. Nonnutritive sweetener in beverages
in high school after school
6. Caffeine-free
All Students During the School Day
7. Tier 1 foods and beverages
8. Water available and free
9. Sport drink limited to student athletes
with >1 hr vigorous activity via coach
10. Not for reward or punishment for
behavior or academic achievement
11. Minimize marketing of Tier 2 foods
and beverages
After-School Setting
12. Tier 1 for elementary and middle school
Tier 1 and Tier 2 for high school
Fund Raising
13. Tier 1 on campus during school day for
all students
Tier 1 and Tier 2 on campus after school
for high school students
Encourage Tier 1 and Tier 2 for evening
and community events that include
adults and students
Action for Implementation
1. Policy making bodies providing:
• Regulatory guidance
• Designate responsibility
• Performance guidelines
• Technical and financial support
2. Federal agencies and food and
beverage industry
• Identification system for Tier 1 and Tier 2
• Whole grain and combination products
Key Elements for Success
Awareness and understanding of the
standards by schools, parents, students, and
federal, state, and local as well as other
private stakeholders.
CDC Implementation Guide – under
Concluding Remarks
Federal school nutrition programs are the main
source of nutrition provided at school. However,
if opportunities for students to select
competitive foods and beverages arise, they
should be used to encourage greater
consumption of fruits, vegetables, whole
grains, and nonfat or low-fat dairy foods.
The recommendations in this report ensure that
competitive foods and beverages are consistent
with the DGA and will help encourage students
to develop healthful life-long eating patterns.
“Remember when we
used to have to fatten the
kids up first?”