Overweight kids: Schools take action

Erykah Martin's lunch is a model of nutrition: a lettuce and carrot salad, an apple, a granola bar, and (the one kid-like concession) chocolate milk.

Salad is the second-grader's favorite lunch item, she says, "'cause all the things you put in it is healthy and good." She wrinkles her nose and shakes her black braids at the idea of hot dogs, the cafeteria's hot lunch option that day.

The salad bar at Chicago's Nettelhorst Elementary School, where Erykah goes, is one way the school is promoting healthier choices for students. It also teaches nutrition, has an after-school cooking program, has reinstituted recess, and has dance and physical education classes - the sorts of programs needed at far more schools, children's health advocates say, given the rise in childhood obesity.

The trends can seem alarming - one recent study showed that 17 percent of children and adolescents were overweight in 2004, up from 14 percent just five years earlier. But more and more, schools are starting to address the problem.

By this summer, they must meet a federal mandate for a comprehensive wellness plan. Recently introduced federal legislation would require new minimum nutrition standards for school lunches. Numerous states are passing laws aimed at better food and more physical activity for students. A few individual schools, like Nettelhorst, are also taking the initiative.

"I'm very encouraged by what is occurring in schools," says Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University. "One can just see the landscape changing.... At the moment, it's still a minority of schools, but the number is growing and the state legislatures are getting involved in requiring schools to change."

The problem, he and others agree, is critical. One recent New York study showed that 1 in 4 kids in the city's Head Start program was obese by the age of 2, and 40 percent of the Head Start kids were either obese or overweight. The Centers for Disease Control and Prevention doesn't have an "obese" designation for children. But its National Health and Nutrition Examination Survey - considered the gold standard of weight data because it uses actual measures instead of self-reporting - showed that 17 percent of children between ages 2 and 19 were overweight in 2004. Another 17 percent were at risk of becoming so.

Studies show that overweight children are highly likely to become obese adults, who have an elevated risk of many health problems. And America's growing obesity rate is a prime reason for rapidly rising healthcare costs, health experts say.

Schools have become the major legislative target for obvious reasons: Kids eat many meals there - often breakfast and lunch - and policy can regulate schools in a way that's impossible with families.

"Schools alone didn't cause the problem, and schools alone can't solve the problem, but we'd be hard-pressed to solve it without schools," says Howell Wechsler, director of the Division of Adolescent and School Health at the Centers for Disease Control.

A few reform advocates see particular promise in the wellness policies that all schools must have in place by the coming school year. "It really gives us an opportunity to have this discussion in a way that can get systemwide changes," says Alicia Moag-Stahlberg, director of Action for Healthy Kids, a national group that works with schools and is helping many create their wellness policies. "And kids have to be part of it, too. If you make changes to the school meal line without kids' involvement, you may just encourage more bootlegging out of the locker."

The reasons for the obesity problem are varied: bigger portion sizes, kids who spend more time in front of TVs and video games, neighborhoods that aren't safe enough for outdoor play or walking or biking to school.

And experts say that school-nutrition guidelines are outdated. For example: jelly beans, lollipops, and breath mints are not allowed, but donuts, French fries, and soda are. Even more troubling is the food not sold in cafeterias.

"There is junk food for sale in just about every school in America," says Allison Dobson, a spokeswoman for Sen. Tom Harkin (D) of Iowa, who is sponsoring a bipartisan bill to change the standards and make them apply to all food in schools, including that in vending machines. "This is a time when we should be molding our kids' habits."

Critics of such bills - primarily the snack-food industry, but also some schools worried about losing revenue - often say kids won't eat healthier options.

"We feel that teaching kids to lead a balanced, healthy lifestyle and make smart choices is more important than restricting one category of food," says Jennifer Phillips, a spokesperson for the American Beverage Association. She notes that the ABA has adopted a voluntary policy that limits high school vending-machine options to 50 percent soft drinks, and supplies elementary schools only with water and 100 percent juice. "We think it should be a balance ... and more about teaching children about nutrition and exercise."

But all that's needed may be a little creativity, says Christina Paxson, a Princeton University professor of public affairs and editor of a recent report on childhood obesity. Successful programs "engage kids in learning about healthy food, usually in very hands-on ways. They get them to help prepare the food instead of just lecturing them, they get them engaged in physical activity in fun ways, sometimes in unconventional nongym-class ways."

That sort of engagement has worked at Nettelhorst, which was part of a pilot project that put salad bars in three Chicago elementary schools. A study of the project showed that without any nutrition education, few kids chose the salads; with education, the number doubled. On some days, nearly a third of Nettelhorst students choose salad. No junk food is available.

Susan Kurland, Nettelhorst's principal, also made the decision to bring back recess - a rarity in Chicago, where a recent survey showed just 6 percent of elementary schools have a recess of at least 20 minutes. "There isn't anything happening here that can't happen at any other school," she adds. "Somewhere along the way we lost the idea that school is where you teach kids how to live life."