1. HEALTHY SCHOOL ENVIRONMENTS: POLICY AND NUTRITION Elizabeth Walker, MS

2. Policy and Programs  Policy  Create long-term, sustainable change  Ensure that all children have the same opportunities no matter what community or school they reside in  Use national standards and examples  Programs  Evidence based programs and tailor to your environment  Supports policy change and implementation

3. Key Dietary Recommendations for a Healthy Life  Fruits and Vegetables  At least 2 cups of fruit and 2 and ½ cups of vegetables per day.  Eat a variety of colors like dark green, orange, reds  Whole grains  At least half the grains consumed should be whole grains.  Milk  Children 2-8 years of age need at least 2 cups of 1% or fat-free milk or its equivalent per day.  Children and youth 9 and older need at least 3 cups of 1% or fat-free milk or its equivalent per day.

4. Key Dietary Recommendations for a Healthy Life  Fats  Keep total fat intake to 25% - 35% of calories, <10% of saturated fat, and little or no trans fat.  Encourage eating healthy fats from sources like fish, nuts and vegetables oils.  Choose lean meats, beans, poultry and low-fat or fat-free dairy products  Sodium  Consume less than 2,300 mg of sodium per day (1 tsp)  Choose foods with little added salt.  Other foods  Choose foods with little added sugar or caloric sweeteners.

5. What are our children and youth currently eating?

6. Dietary Patterns of US Children and Youth 2007 YRBSS:  21.4% eat at least 5 fruits and vegetables per day  33.8% have at least 1 soda per day  14.1 drink at least 3 glasses of milk per day What children and youth eat at lunch? (SNDA III)  75% drank milk: 19% skim, 41% One Percent, 50% flavored  36% ate canned fruit or fresh fruit  30% consumed vegetables except french fries 6% orange/dark green vegetables  1% ate whole grains  38% consumed dessert or snack at lunch

7. Competitive Food Consumption  Overall, almost half, or 40%, of school children consume competitive foods at school  31% of students obtained competitive foods at lunch  About 277 calories are taken in when kids eat competitive foods. Of that, 177 calories are from junk foods-- most common foods were dessert or snack items  Average calories per day from junk foods= 177 cal/day  Average school year (180 days)= 31,850 calories or about 9 lbs from competitive foods  Average school career (12 years)=382,200 or 109 lbs from competitive foods alone

8. US School Food Environment

9. How Can the School Environment Support Growing Children and Youth?

10. School Environments Can Make a Difference Challenges to a healthy school environment:  Access to foods of minimal nutrition value  Inconsistent guidelines for foods and beverages  Attitudes of school community members to change  Access to healthy foods

11. Comprehensive Nutrition Plan  Addresses:  Competitive Foods  School Meals: Breakfast and Lunch  Increasing access to fruits and vegetables  Limiting marketing of unhealthy foods  Nutrition Education/Health Education  Afterschool time

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13. Competitive Foods and School Meals

16. School Environments Can Make a Difference Nutrition guidelines/standards can lead to:  Decreased total and saturated fats  Decreased sales of chips and sodas  Increased availability of healthy foods and beverages for children and staff.  Improved dietary intake of children

17. State Standards: 51% of districts Availability of Unhealthy Snacks: Districts Adopting Connecticut State Standards versus Local Standards State Standards: 51% of CT districts (n=89) Local Standards: 49% of CT districts (n=87) Schwartz M. School Wellness Policies: Opportunities for Public Policy, Rudd Center for Food Policy and Obesity, Yale University; 2009.

18. LEAF Evaluation Woodward-Lopez, G. Center for Weight and Health, UC Berkeley

19. Is it possible to do?  Recent studies show little or no budget impact from changing standards.  West Virginia- 80% of principals reported little or no changes from new state-wide competitive food standards.  In Massachusetts- 70% of food service directors reported no change in food revenue while an additional 26% reported an actual increase in revenue when they changed their food options and/or marketing in the a la carte lines.  Connecticut-pilot study showed no change in food cost  California-showed a dramatic increase in school meal participation  Training and technical support are important to help educate nutrition and school staff on the policies and new practices.  Marketing and education help to inform families and students of the new changes so they can be supportive.

20. Key Factors for Policy Change from Lincoln County School District, WV  Detailed explanation and guidance about policy from the state  Networking with other Food Service Directors (coop)  County/District level ownership  Understanding WHY, WHO, and WHAT at all levels

21. Education to District & Schools  Administrative Cabinet  Why, Who wrote it, District impact and approach  School Principals  What it meant for them  selling, serving, distribution of foods and beverages, not just food service  Cooks  Training – WHY, WHAT, HOW  Inservice Day Meetings  Ownership in change process

22. Important Strategies to Support Change  Food Service Cooperative  Leveraging resources to taste and test new products  Student Buy-in  TASTE TESTING TUESDAYS!

23. Taste TestingProduct:__________________ Description of product:__________________ Product Label:________________________ Portion size:______ Calories:_________ Total Fat:________ Sat. Fat:_________ Trans Fat:________ Sodium:__________ Whole grain: No__ Yes___ Preparation Guide:____ Delivery from Vender:________________________ Taste Testing Date:__________________________ Overall Apperence:_____good______poor Acceptability:______good_______fair_______poor Would you try this product again?____yes____no If no, why? _________ Taste Test Tuesdays Evaluation Form

24. Important Resources Needed to Support Change  Support and leadership from the Department of Education to inform, reinforce, and communicate to District and School Administrators  Understanding and explaining the WHYs of the policy

25. Evaluation & Accountability  Food Service Director  Coordinated Review & Evaluation and the School Meals Initiative Report  School Building  Schools submit local wellness activities each quarter (at least 3 activities/year)

26. School Wellness Activity Report LINCOLN County Board of Education Wellness Activity for 2009-2010 School: Name of Activity: Target Population: # of Participants: Description of Activity: Principal: School Wellness Representative: ***3 activities recommended per school year***

27. Evaluation & Accountability  School District  Conduct a School Health Index every 2 years  Compile comprehensive report to share with administration and revise policy as needed  State  Submit School Wellness Policy report every 2 years to the state

28. Student Taste Tests and Engagement  Vermont Student Taste Test materials  Students Taking Charge  www.actionforhealthykids.org www.actionforhealthykids.org  Alliance for a Healthier Generation Empower Me  www.healthiergeneration.org www.healthiergeneration.org

30. Institute of Medicine Nutrition Standards  In 2007, the IOM released guidelines for nutrition standards in schools.  Convened a committee of experts to review science and nutrition needs of children and youth to establish guidelines.  Focuses on beverages and foods sold outside the federal breakfast and lunch programs.  Emphasizes only offering whole fruits/vegetables, whole grains, non-fat and low-fat milk and dairy.  Sets standards for:  Portion sizes, calories, all fats, sugar, and sodium  When and where foods should be offered.

31. Other Nutrition Standards  USDA Healthier US School Challenge (2008)  Created standards by adapting the IOM and the 2005 Dietary Guidelines for Americans standards.  Created by a Food Nutrition Service task force.  Alliance for a Healthier Generation and American Heart Association (2006)  Establishes voluntary guidelines related to the sale of beverages in schools.  Reduces portion sizes, and sets standards for calories, all fats, sugar, and sodium.  Created in collaboration with the food and beverage industry.  School Nutrition Association (2008)  Created standards by adapting IOM and Alliance for Healthier Generation standards.  Created by SNA task force.

32. Nutrition Standards Should Address:  Content of the Food:  Calories/Portion  Fat (total, trans, sat)  Sugar  Sodium  Types of beverages Water Milk (1%, skim) Other beverages  Fruits and Vegetables  Whole Grains  Settings  Vending  A la carte  School stores  Fundraisers  Celebrations  Marketing  Afterschool

33. Skinny on Juice  Orange Juice: 8oz. juice contains 112 calories, 0.1 g dietary fiber, and 20.8 g sugar, while the fruit has 45 calories, 2.3 g dietary fiber, and 9 g sugar.  Apple Juice: 8 oz. has 120 calories, 0.3 g dietary fiber, and 27.2 g sugar; the fruit has 72 calories, 3.3 g dietary fiber, and 14.3 g sugar.  Grape Juice: 8 oz. has 154 calories, 0.3 g dietary fiber, and 37.6 g sugar; a cup of grapes has 62 calories, 0.8 g dietary fiber, and 15 g sugar.

34. Sodium  Recommendations: 5.7 g to 3.7 g per day.  Average use in the United States:  Men: 10.4 g of salt per day  Women: 7.3 g per day  Reducing dietary salt by 3 g per day is projected to reduce the annual number of  Heart Disease by 60,000 to 120,000  Stroke by 32,000 to 66,000, and myocardial  Heart Attacks by 54,000 to 99,000  Deaths from any cause by 44,000 to 92,000.  Would save $10 billion to $24 billion in health care costs annually

35. West Virginia Nutrition Standards (2008) 1.Limit total calories to no more than 200 per product/package 2.Limit fat to: a)Total fat to no more than 35% of calories per product/package excluding nuts, seeds or cheese b)Saturated fat to less than 10% of the total calories. c)Trans fat to less than or equal to 0.5 grams per product/package 3.Reduce sugar content of food items to no more than 35% of calories per product excluding fruits. 4.Limits sodium to no more than 200 mg per product/package 5.Prohibit caffeine containing beverages with the exception of those containing trace amounts of naturally occurring caffeine substances 6. Prohibit the sale, service or distribution of any foods containing non-nutritive sweeteners 7.Created guidelines for foods brought from the home to the classroom.

36. School Meals Rhode Island:  Whole Grains: All of the grains served that are considered as a “bread serving” (rice, bread, pasta, cereal etc.) as part of reimbursable meals & snacks will be at least 51% whole grain. This percentage increases by 10% per year until it reaches 100% whole grain by 2013/2014. Grain products must have no more than 7 grams of total sugar per ounce (grains with fruit may have more).  Fruits and Vegetables: In all menu planning options, schools must serve, at a minimum: 2 servings of fruit and/or vegetable per breakfast, 3 servings of fruit and/or vegetable per lunch, 1 serving of fruit and/or vegetable per each after school snack.  Fruits and Vegetables: Schools must offer at a minimum 3 different fruits in 1 week, 5 different non-fried vegetables in 1 week, 1 serving of fruit or vegetable per day will be dark green or orange. One serving of fruit or vegetable per day must be fresh or raw.  Juice: Schools may offer no more than one serving of 100% juice per day for breakfast and lunch and one serving of 100% juice for every 5 consecutive snacks served.  Sugar/Added Sugars: 100% juice or milk served as part of school lunch, school breakfast, or after school snack, may have no more than 4 grams of total sugar per ounce.  Sodium: May not exceed 575 mg for all components of school breakfast, 1070 mg for school lunch 1000 mg for soup served as a part of lunch, 350 mg for afterschool snack.  Milk: 1% or skim, non-flavored with no more than 4 grams of total sugar per ounce.  Cooked legumes: One or more servings of cooked legumes must be at least once per week.

39. Comparing Standards Beverages- Tier 1 Tier 1: elementary, middle during and after school, high school during school ItemIOMUSDA HUSSC Alliance for a Healthier Generation School Nutrition Association Water without flavoring, additives, carbonation, or added sugar Non-flavored, no sweeteners (nutritive or non-nutritive), non- carbonated, non-caffeinated without flavoring, additives, carbonation, or added sugar 100% Juice Up to 4 oz (elementary and middle) Up to 8 oz (high school) 100 % full strength with no sweeteners (nutritive or non-nutritive) Up to 6 oz Up to 8oz. (elementary ) Up to 10 oz. (middle) Up to 12 oz. (high school) < 120 calories/ 80z. with at least 10% of recommended daily value of 3 or more vitamins or minerals. Includes 100% juice/water blends with no added sugar Up to 10 oz.

40. Juice 1. A- IOM Standards 2. USDA- Healthier US School Challenge 3. Alliance for Healthier Generation 4. School Nutrition Association 5. Current PA Standards

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42. Increasing Access to Fruits and Vegetables Replacing Unhealthy with Healthy:

44. Increasing Access to Fruits and Vegetables  Have an overall plan  Requires fruits and vegetables (fresh, frozen, canned or dried) to be served at all points of purchase  Farm to School  School Gardens  Nutrition Education  Student Engagement and Taste Tests

45. What’s Going on in Washington DC?  Let’s Move  Child Nutrition Reauthorization  USDA: Healthier US Challenge

46. Comprehensive Nutrition Plan  Addresses:  Competitive Foods  School Meals: Breakfast and Lunch  Increasing access to fruits and vegetables  Limiting marketing of unhealthy foods  Nutrition Education/Health Education  Afterschool time

47. Resources  NASBE:  Nutrition Needs Assessment process: contact Elizabeth Walker at elizabethw@nasbe.org  Fit, Healthy, Ready to Learn: www.nasbe.orgwww.nasbe.org  Institute of Medicine: www.iom.eduwww.iom.edu  School Meals: Building Blocks (2009)  Nutrition Standards for School Foods (2007)  Alliance for Healthier Generation: www.healthiergeneration.org/ www.healthiergeneration.org/  Action for Healthy Kids: www.actionforhealthykids.orgwww.actionforhealthykids.org  West Virginia: wvde.state.wv.us/nutrition/toolkit/  USDA: Team Nutrition Program: http://www.fns.usda.gov/tn/

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49. Summary