Call to Order and Roll Call
The2nd meeting of the Task Force on Childhood Obesity was held on Tuesday, August 16, 2011, at 10:00 AM, in Room 129 of the Capitol Annex. Senator Katie Kratz Stine, Co-Chair, called the meeting to order at 10:38, and the secretary called the roll.
Guests: Janey Thornton, Ph.D., SNS, Deputy Under Secretary, Food, Nutrition and Consumer Services, United States Department of Agriculture, Washington, D.C.; Janet Mullins, Ph.D., R.D., L.D., Associate Professor, Extension Specialist in Food & Nutrition, University of Kentucky; Jamie Sparks, Coordinated School Health Project Director, and Robin Chandler, Policy Advisor, Office of Next Generation Learners, Kentucky Department of Education; Denise Hagan, Director, Colby Wagoner, MS, Child Nutrition Program Consultant, Jennifer Langfels, Registered Dietician, Child Nutrition Program Consultant, and Angela Voyles, Division of School and Community Nutrition, Kentucky Department of Education; Elizabeth Schmitz, Kentucky Environmental Education Council; Timothy Mayer, Community Team Alliance; Scott Douglas, Coca-Cola; Anne Joseph; Jan Clark, Child Advocacy Today; and Wayne Young, Kentucky Association of School Administrators.
Hungry Kids Act: School Lunch Programs
Janey Thornton, Ph.D., SNS, Deputy Under Secretary, Food, Nutrition and Consumer Services, United States Department of Agriculture, Washington, D.C., stated that all society has a role to play in the obesity epidemic. There is a real hunger problem, not just an obesity problem. Approximately 16.7 million children live in households with food insecurity, and for many, school meals may be the only health food they get all day. Increased consumption of sugar sweetened beverages increased frequency of meals eaten away from home, and continued low consumption of fruits and vegetables are huge factors in the obesity epidemic. There is an increased number of fast food establishments in the United States who advertise less health food and beverage choices. The lack of access to full service grocery stores selling affordable healthful foods and desserts is not limited to just the rural areas. Being physically active is just as important as a healthy diet. Environmental factors beyond the control of individuals contribute to increased obesity rates by reducing the likelihood of healthy eating and active living behaviors. Some environmental factors that influence physical behavior are lack of infrastructure supporting active modes of transportation such as sidewalks and bike facilities, access to safe places to play and be active, access to public transportation, and mixed use and transit oriented developments.
In 2008, the annual healthcare cost of obesity in the United States was estimated to be as high as $147 billion a year, double the amount a decade ago. The annual medical expenses for the obese are estimated to be 42 percent higher than for persons of a health weight. Workplace obesity prevention programs may be an effective way for employers, including local governments, to reduce obesity, lower healthcare costs, lower absenteeism, and increase employee productivity. A healthy learning environment contributes to the success of students. Creating a healthier school and community food and physical activity environment is a challenge that must be met. Policies and environments that affect peoplesí health are determined by the local, state, and federal governments. The initiative, Letís Move, helps parents make healthy family choices, serve healthier food in schools, improve access to healthy, affordable food, and increase physical activity in children.
New Dietary Guidelines for Americans (DGAs) were released this year. New meal patterns for breakfast and lunch scheduled for winter 2011, based on the Institute of Medicine and the DGAs, will have healthier choices. The Healthy, Hunger Free Kids Act of 2011 includes the regulatory authority on all foods sold throughout the schools during the school day. The entire family will benefit from the knowledge children will gain being taught healthier lifestyles and behaviors. Farmers will learn what products need to be grown by working with the entire community. Reversing the obesity epidemic is a shared responsibility. Social and environmental changes are influenced by the efforts of many.
Dr. Thornton answered questions by Senator Stine by saying that Kentucky was one of the pilot states for the Farm to School project in the Jefferson County and Montgomery County school systems. Contact Tina Garland, Kentucky Department of Agriculture, for more information.
Dr. Thornton answered a question by Representative Riner by saying low-income families on SNAP or WIC purchase healthy items at the beginning of the month, but by the end of the month purchase food with lesser nutritional value because they are less expensive. The goal is to figure out ways to encourage people of all income levels to make better food choices.
Dr. Thornton answered a question by Representative Marzian by saying teachers can tell a difference in a childís ability to learn, attention span, and behavior if students are involved in some form of physical activity throughout the day.
††††††††††† A motion to approve the minutes of the June 21, 2011 meeting was made by Senator Pendleton, seconded by Representative Marzian, and approved by voice vote.
Access to Healthy Foods in Kentucky
Janet Mullins, Ph.D., R.D., L.D., Associate Professor, Extension Specialist in Food & Nutrition, University of Kentucky, stated that in 2001 the Journal of Nutrition Education reported when individual and interpersonal changes are not enough to overcome negative environmental influences, changes in the system, environment, and policy may be required. Since 2002, there has been a significant reduction of vending machines in elementary and middle schools. High schools need to improve in this area. Data shows that boys are struggling more with childhood obesity than before. Kentucky agriculture is now capable of feeding more of our citizens. Strengthening local food systems is good for our health and the economy. Facilities need to be rebuilt to aggregate, process, and distribute fresh foods. Evidence-based policies to help normalize weight include Body Mass Index (BMI) monitoring from school physical exams, Farm to School programs, strengthen local food systems, support systems for limited resource families, increased physical activity in child care, schools, worksites, and communities, and school wellness. Everyone has a right to affordable food for good health and well-being. Children need to be taught that food does not come from stores, it comes from the earth.
Dr. Mullins responded to a statement by Senator Pendleton by saying that the sedentary lifestyle cycle needs to be broken.
Dr. Mullins responded to a statement by Representative Marzian by saying that a child will eat healthier if they understand how to grow and prepare food.
Dr. Mullins answered a question by Representative Riner by saying that Kentucky already has a significant investment in the Farm to School program through the actions of the Department of Agriculture, Department for Public Health, the University of Kentucky College of Agriculture and Extension Service, and the partnership with Fit Kentucky.
School Wellness Plans/Coordinated School Health Programs
Jamie Sparks, Coordinated School Health Project Director, and Robin Chandler, Policy Advisor, Office of Next Generation Learners, Kentucky Department of Education; Denise Hagan, Director, Colby Wagoner, MS, Child Nutrition Program Consultant, and Jennifer Langfels, Registered Dietician, Child Nutrition Program Consultant, Division of School and Community Nutrition, Kentucky Department of Education, stated that eight components of a Coordinated School Health Program (CSHP) are comprehensive physical education, comprehensive school health education, nutrition, services, school health services, counseling and social services, healthy school environment, staff wellness, and family and community involvement. The CSHP is an organized set of programs, policies, and activities that consist of assessing the school environment, having a school health and wellness council, and developing an action plan. CSHP is a best practice that is included as a schoolís evidence in the Program Review process. As part of the Program Review process, schools need to create a coordinated school health and wellness council as a subcommittee of their School Based Decision Making Council that would assess the school environment, identify strengths and areas for growth, develop an action play, and create a comprehensive school physical activity program (CSPAP) as a part of a schoolís wellness policy.
Alcohol and drug use, injury and violence, tobacco use, unhealthy dietary behaviors, physical inactivity, and sexual risk behaviors are the six priority health-risk behaviors of youth that contribute to the leading causes of illness and death by Kentuckyís youth. In Kentucky, these six priority health-risk behaviors are monitored by the Centers for Disease Control and Prevention through the Youth Risk Behavior Survey (YRBS). Lifestyles and behaviors are engrained in us at an early age and it is time to learn new ones. The Pediatric Exercise Science reports intense physical activity programs have positive effects on academic achievement, including increased concentration, improved mathematics, reading, and writing test scores, and reduced disruptive behavior. One comprehensive CSPAP that would improve health and academic performance is Letís Move in School. The goal of the program is to ensure that every school provides a comprehensive school physical activity program with quality physical education as the foundation so that youth will develop the knowledge, skills, and confidence to be physically active for a lifetime. Letís Move in School is urging physical educators, parents, school administrators, and policymakers to get involved in bringing quality physical education and physical activity to schools through a CSPAP. The goals of the CSPAP are to provide a variety of school-based physical activity opportunities that enable all students to participate in physical activity each day and provide coordination among the CSPAP components to maximize understanding, application, and practice of the knowledge and skills learned in physical education so that all students will be fully physically educated and well equipped for a lifetime of physical activity.
Kentucky, Alabama, Georgia, North Carolina each received $15,000 to help adopt, strengthen, or implement policies that promote health eating and physical activity in schools to fight childhood obesity. The funding is one aspect of a National Association of State Boards of Education (NASBE)/Robert Wood Johnson Foundation Obesity Prevention Project. According to the NASBE, health and success in school are interrelated. Schools cannot achieve their primary mission of education if students and staff are not healthy and fit physical, mental, and socially. There is a growing body of research that says children who are obese have greater absentee rates and lower academic achievement, along with all the other health complications. A report to the Kentucky Board of Education (KBE) health subcommittee on guidelines and regulations for nutrition and physical activity is due in October 2011.
KRS 158.852 requires each district to appoint a food service director who is responsible for the management and oversight of the food service program in the district. The school food service director or person responsible for menu planning must hold a School Food Service and Nutrition Specialist (SFNS) credential or a level 2 certificate issued by the School Nutrition Association. All continuing education must be related to applied nutrition and healthy meal planning and preparation. KRS 158.854 requires KBE to promulgate an administrative regulation specifying the minimum nutritional standards for all foods and beverages sold outside the National School Breakfast (NSB) and National School Lunch Programs (NSLP). The administrative regulation will address serving size, sugar, and fat content of the foods and beverages. Competitive food means any food or beverage items old in competition with the NSB and NSLP. No school may sell competitive foods or beverages from the time of the arrival of the first student at the school building until thirty minutes after the last lunch period. Habitual violations of five times or more within a six-month period will result in a six-month ban on competitive foods sales for the violating school. KRS 156.160 requires all revenue to go Food Service. School day approved beverages are water, one hundred percent fruit juice, low-fat milk, and any beverage that contains no more than ten grams of sugar per serving. Only school day approved beverages may be sold in elementary schools during the school day in vending machines, school stores, canteens, or fundraisers.
KRS 158.856 requires each school food service director to annually assess school nutrition including the nutritional value of all foods and beverages available for students. The director must submit a report on the list of foods and beverages that are available to students, including the nutritional value and recommendations for improving the school nutrition environment. KBE must develop an assessment tool for each school district to use to evaluate its physical activity environment. The evaluation must be completed annually and released to the public at the time the nutrition report is released. The local school board will discuss the findings of the nutrition report and physical activity report and seek public comments during a publicly advertised board meeting following the release of the reports. A compilation of the summary of findings and recommendations of the local school boards will be submitted to the KBE.
The goals of the Fresh Fruit and Vegetable Program (FFVP) are to create healthier school environments, expand and increase the variety and amount of fruits and vegetables children experience and consume, and combat childhood obesity by helping children learn more healthful eating habits through the consumption of healthy foods and nutrition education. Schools submit monthly reimbursement reports of allowable costs and develop an implementation plan involving teachers and other school staff to decide when, where, and how to implement the program and what mix of fresh fruits and vegetables offered to the children. The schools have to agree to make free fresh fruits and vegetables available to all enrolled children during the school day, have documented support of the food service manager, principal and district superintendent, and serve a high number of low-income children.
The community eligibility option (CEO) provides an alternative to household applications for free and reduced price meals in high poverty local educational agencies (LEAs) and schools. LEAs or schools electing the option agree to serve all students free lunches and breakfasts for four successive school years. Meal program claims are based on the percentage of identified students multiplied by a factor of 1.6. Identified students are defined as the students certified for free meals not through the submission of individual applications. Students included are directly certified through Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for needy Families (TANF), and Food Distribution Program on Indian Reservations (FDPIR) participation as well as homeless on the liaison list, income-eligible Head Start, pre-K Even Start, migrant youth, runaways, and non-applicants approved by local officials. Foster children certified through means other than an application are also included. The Board of Education counties participating in the CEO are Carter, Christian, Clay, Elliott, Floyd, Harlan, Knox, Lee, Madison, McCreary, Monroe, Owsley, Pike, and Wolfe. The independent Board of Education counties are Jenkins, Mayfield, and Paducah.
There being no further business, the meeting was adjourned at 12:40 p.m.