1. WHY HEALTHIER LUNCHES? Not Just Because We Say So Sandra Richardson, MPH Student Walden University PH 6165-5 Environmental Health Instructor: Dr. Donald Goodwin Fall, 2009 Middle High School Students

2. 2 INTRODUCTION Purpose: Educate students on the necessity of healthy eating and the need to change school lunch menus. Expected outcome: To convince students of the benefits of healthy meals and deter decreased participation in lunch programs.

3. 3 Why Change? Health Concerns  16% of children in the U.S. between 2 and 6 are obese.  Obesity increases the risk of chronic diseases:  Type 2 Diabetes  Cardiovascular Disease  Liver Disease  Quality of life can be compromised with these conditions (Centers for Disease Control and Prevention [CDC], n.d.)

4. 4 Why Change? Cont’d More on Chronic Disease Type 2 Diabetes  Approximately 24 million Americans have type 2 diabetes, and approximately 57 million more are at risk.  Diabetes strikes every 20 seconds in the U.S. (American Diabetes Association, 2009)

5. 5 U.S. Population With Diabetes or at Risk 1= U.S. population 304M 2= Population with diabetes 24M 3= Population at risk for diabetes 57M American Diabetes Association, 2009 U.S. Census Bureau, 2009

6. 6 Why Change? Cont’d More on Chronic Disease Cardiovascular Disease (CVD)  Approximately 70% of obese children have at least one risk factor for CVD  Approximately 39% of obese children have two or more risk factors for CVD Liver Disease  Fatty liver disease causing inflammation leading to liver damage if not remedied (CDC, n.d.)

7. 7 Why Change? Cont’d Psychosocial Concerns  Systematic social discrimination  Low self-esteem  Academic performance  Good nutrition linked to enhanced academic performance (CDC, n.d.) (Florence, Asbridge, and Veugelers, 2008)

8. 8 NUTRITION BASICS USDA Recommended Minimum Caloric Intake Requirements (Lunch):  Preschool – 517  Grades K-6 – 664  Grades 7-12 – 825 (United States Department of Agriculture [USDA], n.d.)

9. 9 Nutrition Basics Cont’d Daily Recommended Caloric Intake Calories Girls Boys Total Daily Meals U.S. Department of Health and Human Services, n.d.

10. 10 Nutrition Basics Cont’d Basic Food Groups  Meat/Fish/Poultry  Dairy  Fruits and Vegetables  Bread and Grains ( USDA, n.d. )

11. 11 Basic Food Groups Cont’d Meat/Fish/Poultry Provides protein (building blocks for the bodies tissues Healthier sources include nuts, beans, fish, chicken, lean beef, eggs in limited amounts Fatty sources include fatty beef, pork, lamb, bologna, salami, etc., - recommend very limited consumption Daily Requirements: Ages 2-8 = 2-4 oz. Ages 9-13 = 5 oz. Ages 14-18 = 5-6 oz. (USDA, n.d.)

12. 12 Nutrition Basics Cont’d Dairy Provides Calcium (builds bones and teeth) Sources include milk, cheese, yogurt, & dark leafy greens Low-fat forms are healthier Daily Requirements: Ages 2-8 = 2 cups* Ages 9-13 = 3 cups* Ages 14-18 = 3 cups* *One cup = 1-1/2 – 2 oz cheese (USDA, n.d.)

13. 13 Nutrition Basics Cont’d Fruits and Vegetables Provides vitamins, minerals, and fiber (helps to regulate the body) Sources include apples, tomatoes, plums, berries, lettuce, kale, broccoli and much more! Daily Requirements Ages 2-8 = 2 cups Ages 9-13 = 3 cups Ages 14-18 = 3 cups (USDA, n.d.)

14. 14 Nutrition Basics Cont’d Breads and Grains Provides carbohydrates, B vitamins, and minerals (provides energy to the body) Healthier sources include whole grain breads, pasta, and cereals Less healthy sources include refined starches (white bread, cookies, etc) and should be eaten in minimum amounts (USDA, n.d.)

15. 15 Breads and Grains Cont’d Daily Requirements: Ages 2-3 = 3 oz. Ages 4-8 = 4-5 oz. Girls Ages 9-13 = 5 oz. Girls Ages 14-18 = 6 oz. Boys Ages 9-13 = 6 oz. Boys Ages 14-18 = 7 oz. (USDA, n.d.)

16. 16 What about Snacks? Vending machine snacks and drinks  Eat this: (yogurt, fruit, fruit juice, nuts, low-fat cookies, pita chips) Snacks with low sugar and fat content Snacks with some nutritional value  Not that: (soda, regular cookies, chips, candy bars) Snacks high in fats and sugars Snacks that are nutrient-poor

17. 17 Drink This Not That 8 oz juice 12 oz soda ( Nutritiondata.com, n.d.) Good Bad

18. 18 Conclusion Schools are on the right track with the change to healthier lunch programs Healthy eating reduces the risk for developing obesity and chronic diseases Healthy eating also enhances academic performance

19. 19 Helpful Sites United States Department of Agriculture. (n.d.). Inside the pyramid. Retrieved October 5, 2009, from http://www.mypyramid.gov/pyramid/index.html:This site provides guidance on recommended daily intake for each food group. http://www.mypyramid.gov/pyramid/index.html Eat fit. (n.d.). Retrieved October 19, 2009 from http://eatfit.ucdavis.edu/levelone/whatis.html: This site was developed to challenge and guide 5 th -9 th graders in developing healthy eating habits, as well as physical fitness activities. http://eatfit.ucdavis.edu/levelone/whatis.html Nutrition Data. (n.d.). Retrieved October 19, 2009, from http://www.nutritiondata.com/: This site provides detailed information on the nutritional content of a variety of foods. http://www.nutritiondata.com/

20. 20 References American Diabetes Association (2009). It is time to stop diabetes. Retrieved October 12, 2009, from http://www.diabetes.org/for- media/pr-is-it-time-to-stop-diabetes.jsphttp://www.diabetes.org/for- media/pr-is-it-time-to-stop-diabetes.jsp Centers for Disease Control and Prevention. (2009). Availability of less nutritious snack foods and beverages in secondary schools ---selected states, 2002—2008. Mortality and Morbidity Weekly Report, 58, p. 1- 4. Retrieved October 12, 2009, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e1005a1.htm?s _cid=mm58e1005a1_e http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e1005a1.htm?s _cid=mm58e1005a1_e

21. 21 References cont’d Centers for Disease Control and Prevention. (2007). National Diabetes Fact Sheet, 2007. Retrieved October 9, 2009, from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf Centers for Disease Control and Prevention. (n.d.). Childhood Overweight and Obesity. Retrieved October 12, 2009, from http://www.cdc.gov/obesity/childhood/index.html http://www.cdc.gov/obesity/childhood/index.html Florence, M., Asbridge, M. & Veugelers, P. (2008). Diet quality and academic performance. Journal of School Health, 78(4), 209-215. Retrieved October 5, 2009, from http://www3.interscience.wiley.com/cgi- bin/fulltext/119393960/PDFSTART http://www3.interscience.wiley.com/cgi- bin/fulltext/119393960/PDFSTART

22. 22 References cont’d Institute of Medicine of National Academies. (2009). Local Government Actions to Prevent Childhood Obesity. Retrieved October 12, 2009, from http://iom.edu/en/Reports/2009/ChildhoodObesityPreventionLocalGov ernments.aspx http://iom.edu/en/Reports/2009/ChildhoodObesityPreventionLocalGov ernments.aspx Nutrition Data. (n.d.). Retrieved October 19, 2009, from http://www.nutritiondata.com/ http://www.nutritiondata.com/ Shilts, M., Lamp, C., Horowitz, M., Townsend, M. (2009). Pilot study: EatFit impacts sixth graders’ academic performance on achievement of mathematics and English education standards. Abstract retrieved October 19, 2009, from http://www.jneb.org/article/PIIS1499404608006921/abstract http://www.jneb.org/article/PIIS1499404608006921/abstract

23. 23 References cont’d United States Census Bureau. (2009). State & County QuickFacts. Retrieved November 4, 2009, from http://quickfacts.census.gov/qfd/states/00000.html United States Department of Agriculture. (n.d.). Inside the pyramid. Retrieved October 5, 2009, from http://www.mypyramid.gov/pyramid/index.html http://www.mypyramid.gov/pyramid/index.html United States Department of Agriculture. (2000) Menu planning in the national school lunch program. Retrieved October 19, 2009, from http://www.fns.usda.gov/cnd/menu/menu_planning.doc http://www.fns.usda.gov/cnd/menu/menu_planning.doc

24. 24 References Cont’d United States Health and Human Services. (n.d.). Dietary Guidelines for Americans. Retrieved November 4, 2009, from http://www.health.gov/DietaryGuidelines