A few days ago, we posted a synopsis of the first part of the Healthy Choices for Healthy Children Act that is working its way through both the Senate and House of Representatives in Ohio. The bill proposes 3 key areas of action, the following is Dr. Lisa Simpson’s testimony on behalf of the bill, as it pertains to the second and third areas of action:
Make Healthy Nutritional Choices Available to Children and Youth: School Nutritional Standards and School Breakfasts.
This bill will enable Ohio to catch up with over 19 states which have already established nutritional standards for school meals and snacks that go beyond existing USDA requirements and 27 states that have nutritional standards for competitive food products sold a la carte, in vending machines, in school stores or at bake sales.
Implementing these nutritional standards is recommended by national organizations. These include the Robert Wood Johnson Foundation’s Center for Preventing Childhood Obesity as well as the recently published Recommended Community Strategies and Measurements to Prevent Obesity in the United States. (MMWR, June, 2009). The evidence on these interventions is growing and promising.
Systematic research reviews have reported an association between the availability of fruits and vegetables and increased consumption.
A 2-year randomized control trial of a school-based environmental intervention that increased the availability of lower-fat foods in cafeteria à la carte areas indicated that sales of lower-fat foods increased among adolescents attending schools exposed to the intervention. In addition, in a recent review (2008) of 38 studies examining school based interventions, there were 20 that combined diet and physical activity and of these 9 had significant and positive differences between intervention and control schools for BMI. Research has also shown that reducing the cost of healthier foods increases the purchase of healthier foods. For example, one study indicated that sales of fruits and carrots in high-school cafeterias increased after prices were reduced. In addition, interventions that reduced the price of healthier, low-fat snacks in vending machines in school and work settings have been demonstrated to increase purchasing of healthier snacks.
The final aspect of the focus on nutrition is by expanding the availability of free school breakfasts to all children who are eligible for either free or reduced price breakfasts. Currently, over 60% of low income students in Ohio do not participate.
Measure our Progress: Extending BMI Screening to all Ohio Schools
The final piece of our three pronged approach is to measure our progress. The legislation requires BMI screenings upon school entry and in 3rd, 5th and 9th grades. The Institute of Medicine recommends annual school-based BMI screenings with screening results communicated to parents. The American Academy of Pediatrics recommends that BMI be calculated and plotted annually as part of normal health supervision. Twenty states have passed BMI screening requirements in schools or legislation requiring weight-related assessments other than BMI.
Measuring BMI coupled with parent education about their child’s weight status and health risks is an important step in motivating action and will allow population based surveillance of the impact of school actions to reduce obesity.
We’re hopeful this bill will make it’s way through the State House quickly and will become law sooner rather than later. The kids need it. We’ll keep an eye on it.