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http://docs.schoolnutrition.org/newsroom/jcnm/07spring/thompson/index.asp

The Increased Availability and Marketing of Fruit, Juice, and
Vegetables to Middle School Students Increases Consumption
Victoria Thompson, DrPH, MS; Karen Weber Cullen, DrPH, RD; Kathy B. Watson, MS;
Issa Zakeri, PhD.

The objectives of this intervention were to determine whether middle school student
consumption of fruit, juice, and vegetables (FJV) during school lunch would be
increased by: 1) increasing FJV availability and accessibility in the middle school
school lunch snack bar/a la carte line; and 2) combining increased FJV availability
and accessibility with a social marketing campaign...

The National School Lunch Program (NSLP) serves 28 million students each day
(FNS, 2006). Attention has focused recently on the types of foods available outside
of the NSLP meal (GAO, 2004; Gordon et al., 1995). Students gain access to snack
bars, a la carte lines, and vending machines in middle school (Cullen et al., 2000;
Fox et al., 2001). Previous research suggests that these school food environments
may have a negative impact on NSLP participation and student consumption
(Blanchette & Brug, 2005)… Middle school students with access to snack bar foods
consumed fewer fruit and vegetable (FV) servings compared with elementary school
students who only received NSLP meals (Cullen et al., 2000). Among students
followed from elementary into middle school, consumption of fruit, regular
vegetables (i.e., not fried) and milk decreased, while consumption of fried vegetables
and sweetened beverages increased (Cullen & Zakeri, 2004). The number of school
snack vending machines was negatively related to lunch fruit consumption (Kubik et
al., 2003).

School-based interventions have been implemented to encourage student FV
consumption. Elementary school programs have had some success. These
interventions included classroom and cafeteria components (Gortmaker et al., 1999;
Perry et al., 1998; Perry et al., 2004; Reynolds et al., 2000). Only one (Gortmaker et
al., 1999) of two middle school nutrition programs found increased FV consumption.
Two studies in secondary schools used social marketing to promote FV (Nicklas et
al., 1998) and low-fat food sales (French et al., 2004). No changes in FV
consumption were found (Nicklas et al., 1998), but increases in low-fat food sales
were achieved (French et al., 2004).

The purpose of this research is to examine whether a cafeteria-based social
marketing campaign promoting fruit, juice and vegetables (FJV) would increase
consumption of these food items among middle school students. Social marketing
adapts business marketing practices to a social idea or practice and attempts to
achieve an action change, not just an improvement in knowledge, in a specific target
population (Andreasen, 1995). Strategies are developed to deal with each element
considered important in marketing: Product, Price, Place, and Promotion (Andreasen,
1995).




The overall intervention compliance rates among the schools receiving the
intervention were 92.1% and 87.8% for Intervention A and Intervention B schools,
Resolved: The Baltimore City Board of School Commissioners for Baltimore City         1
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007

respectively. In this study, students did not consume more FJV simply because they
were available and accessible in the school lunch snack bar/a la carte line during
lunch. This finding was disappointing because previous research with young children
has shown that increased exposure to new foods increased consumption (Birch et al.,
1987). The FJV foods provided in this intervention were the ones favored by middle
school youth (Cullen et al., 2005)…

Healthier changes in food consumption were found for cafeteria environmental
interventions for elementary (Perry et al., 2004) and high school children (Conklin et
al., 2005). While classroom nutrition education may be important to the process,
students also should have greater access to healthier choices in elementary school.
The increase in fried vegetable consumption was unexpected. While no potatoes
were included in the social marketing campaign, student consumption of fried
vegetables (usually French fries in the school snack bar or a la carte line) increased
when the posters were included in the intervention. This increased consumption
may be attributed to students considering all potatoes as vegetables;
therefore, the posters, which promoted vegetables, unwittingly may have
reinforced consumption of all vegetables, including those high in fat.

There are several advantages to a school cafeteria environmental intervention. No
classroom time is involved, so student instructional time is not reduced. Plus there is
minimal burden on classroom teachers. The school cafeteria is an ideal place for the
promotion of healthful foods and is an integral component of the Team Nutrition
program [LINK TO:
http://teamnutrition.usda.gov/Healthy/execsummary_makingithappen.html].
However, just providing the foods may not be a strong enough intervention that will
overcome other barriers that may limit consumption. Interventions outside the
school environment also may be needed…

Cited references include:

Conklin, M.T., Cranage, D.A., & Lambert, C.U. (2005). Nutrition information at point
of selection affects food chosen by high school students. The Journal of Child
Nutrition & Management, 29. [Available online at:
http://docs.schoolnutrition.org/newsroom/jcnm/05spring/conklin/index.asp.]

Cullen, K.W., Thompson, V.J., Watson, K., & Nicklas, T. (2005). Marketing fruit and
vegetables to middle school students: Formative assessment results. The Journal of
Child Nutrition & Management, 29. [Available online at:
http://docs.schoolnutrition.org/newsroom/jcnm/05fall/cullen/index.asp.]

Cullen, K.W., & Zakeri, I. (2004). Children’s lunch consumption of fruit, vegetables,
milk, and sweetened beverages changes with access to a la carte/snack bar school
meals. American Journal of Public Health, 94, 463-467.

Food and Nutrition Service (FNS). (2006). Nutrition Program Facts, 2006. [Available
online at: http://www.fns.usda.gov/cnd/lunch/AboutLunch/NSLPFactSheet.pdf.]

Government Acountability Office (GAO). (2004). Competitive Foods are Available in
Many Schools; Actions Taken to Restrict Them Differ by State and Locality. [Available
online at: http://www.gao.gov/new.items/d04673.pdf.]

Resolved: The Baltimore City Board of School Commissioners for Baltimore City           2
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


Prevalence of Overweight and At Risk of Overweight in Fourth-Grade Children Across
Five School-Based Studies Conducted During Four School Years – The Journal of
Child Nutrition & Management Spring 2007
Caroline H. Guinn, RD; Suzanne Domel Baxter, PhD, RD, FADA; Mark S. Litaker, PhD; William O.
Thompson, PhD

This article discusses differences in body mass index (BMI) for age percentiles by
ethnicity, gender, and time, as well as the prevalence of overweight and at risk of
overweight in Fourth Grade children across five studies conducted during four school
years. These five studies concerned either the accuracy of children’s dietary recalls
or children’s social desirability, so weight and height measurements were secondary
rather than primary aims…

The health consequences of overweight and obesity are public health issues that are
among the most burdensome faced in the United States (Office of the Surgeon
General, 2001). Overweight youth are at increased risk for adverse levels of several
cardiovascular disease risk factors (Freedman et al., 1999); in addition, type-two
diabetes, early maturation, and orthopedic problems are exhibited more frequently in
overweight youth (Office of the Surgeon General, 2001). Furthermore, youth with
high body mass index (BMI) for age percentiles have high risks of being overweight
or obese in adulthood (Guo et al., 2002)…

National survey data have shown an increase in the prevalence of overweight among
youth in the United States (CDC, 2006a). In the National Health and Nutrition
Examination Survey (NHANES) III conducted 1988-94, rates of overweight were
11% for all youth ages six to 19 years; rates rose to 16% in NHANES 1999-2002
(CDC, 2006a). Therefore, over a period of approximately ten years, there was a 5%
increase in the rate of overweight among youth.

In 2003, the American Academy of Pediatrics Committee on Nutrition issued
a policy statement concerning the prevention of pediatric overweight and
obesity. It recommended that: 1) children’s BMI be calculated and plotted
once a year; 2) parents and caregivers promote healthy eating patterns by
offering nutritious foods; and 3) policy makers from local, state, and
national organizations and schools be enlisted to support healthful lifestyles
for all children (Committee on Nutrition, 2003).

In a joint position statement, the American Dietetic Association, the Society for
Nutrition Education, and the American School Food Service Association [now the
School Nutrition Association] (2003) asserted that:

“Comprehensive nutrition services must be provided to all of the nation’s preschool
through grade twelve students. These nutrition services shall be integrated with a
coordinated, comprehensive, school health program and implemented through a
school nutrition policy. The policy should link comprehensive, sequential nutrition
education; access to and promotion of child nutrition programs providing nutritious
meals and snacks in the school environment; and family, community, and health
services’ partnerships supporting positive health outcomes for all children.”




Resolved: The Baltimore City Board of School Commissioners for Baltimore City                  3
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007

The Child Nutrition and WIC Reauthorization Act of 2004 required local
education agencies that sponsor school meal programs to establish local school
wellness policies addressing childhood obesity by the beginning of the 2006-07
school year (U.S. Congress, 2004). Results from focus groups conducted with school
foodservice directors in Pennsylvania in June 2005, found that, although the majority
anticipated they would play a lead role in the development of the required local
wellness policies, many expressed varying degrees of comfort with this role
(McDonnell et al., 2006).

The position of the American Dietetic Association (2006) is that “schools and
the community have a shared responsibility to provide all students with access to
high-quality foods and school-based nutrition services as an integral part of the total
education program. Educational goals, including the nutrition goals of the National
School Lunch Program and School Breakfast Program, should be supported and
extended through school district wellness policies that create overall school
environments that promote access to healthful school meals and physical activity and
provide learning experiences that enable students to develop lifelong healthful eating
habits.”

Large and extra-large portion sizes have been implicated as an
environmental contribution to the obesity epidemic (Hill & Peters, 1998).
School meal programs provide age-appropriate serving sizes to the millions of
children who participate in school breakfast, school lunch, and/or school snacks on a
daily basis. Thus, school foodservice directors may want to use serving sizes
provided for school meals and snacks to help educate children, teachers, and parents
about age-appropriate serving sizes.

Cited references include:

American Dietetic Association. (2003). Position of the American Dietetic Association,
Society for Nutrition Education, and American School Food Service Association –
Nutrition services: An essential component of comprehensive school health
programs. Journal of the American Dietetic Association, 103, 505-514.

Centers for Disease Control and Prevention, National Center for Health Statistics.
(2006a, October). Prevalence of overweight among children and adolescents: United
States, 1999-2002. [Available online:
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overwght99.htm.]

Committee on Nutrition. (2003). American Academy of Pediatrics Policy Statement :
Prevention of pediatric overweight and obesity. Pediatrics, 112, 424-430.

Freedman, D.S., Dietz, W.H., Srinivasan, S.R., & Berenson, G.S. (1999). The relation
of overweight to cardiovascular risk factors among children and adolescents. The
Bogalusa Heart Study. Pediatrics, 103, 1175-1182.

Guo, S.S., Wu, W., Chumlea, W.C., & Roche, A.F. (2002). Predicting overweight and
obesity in adulthood from body mass index values in childhood and adolescence.
American Journal of Clinical Nutrition, 76, 653-658.



Resolved: The Baltimore City Board of School Commissioners for Baltimore City           4
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007

Hill, J.O., & Peters, J.C. (1998). Environmental contributions to the obesity epidemic.
Science, 280, 1371-1374.

McDonnell, E., Probart, C., & Weirich, J.E. (2006). School foodservice directors’
perceptions and concerns about local wellness policy development, implementation,
and enforcement. Journal of Child Nutrition & Management, 30 [Available online:
http://docs.schoolnutrition.org/newsroom/jcnm/06spring/mcdonnell/index.asp.]

Office of the Surgeon General. (2001). The Surgeon General’s call to action to
prevent and decrease overweight and obesity. [Available online:
http://www.surgeongeneral.gov/topics/obesity/.]

U. S. Congress, (2004, June). Child Nutrition and WIC Reauthorization Act of 2004.
[Available online:
http://www.fns.usda.gov/cnd/Governance/Legislation/Historical/PL_108-265.pdf.]




Resolved: The Baltimore City Board of School Commissioners for Baltimore City         5
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


Hot potato in the school cafeteria: more districts outsource their food
services, but some raise questions about personnel relations and
savings – School Administrator Sept. 2004

Kate Beem


It's such a simple mandate: Prepare healthy, nutritious meals for the
schoolchildren so they can go about the business of learning.

But operating a school district food service department is anything but
simple. Even in the smallest districts, food service operations are
businesses that must comply with many more rules than those in the
private sector. School food service departments must operate as
nonprofits, yet they need to make enough money to be self-sufficient.
There are federal nutritional guidelines to follow, and the meals have
to be attractive to hard-to-please consumers who are inclined to
complain about "mystery meat."

In fact, most people take the school food service department for
granted, says Donna Wittrock, president of the American School Food
Service Association and executive director of food and nutrition
services for the 73,000-student Denver Public Schools. Few outside
the food service operation understand the difficulty of balancing
government regulations and nutritional worries against marketing and
customer service.

"Most people in a school district don't have a clue how food service
operates," Wittrock says… Outsourcing Options

It's no wonder an increasing number of school districts across the
nation are turning to food service contract management companies to
take over some or all of the responsibility. It's a trend not without
controversy. At stake are the reputations of the districts' own food
service departments and the welfare of longtime employees, who fear
they will get dismissed in the struggle to save money.

The K-12 school food service market is wide open today as far as
contract management companies are concerned. Although the actual
number of school districts using outside contractors to manage their
food operations is sketchy because no agency tracks the practice, the
figure pales in comparison with the saturated higher-education
market. According to a 2000 study by the Centers for Disease Control

Resolved: The Baltimore City Board of School Commissioners for Baltimore City         6
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


and Prevention, food service management companies operate in
almost 17 percent of U.S. schools.

Outsourcing food services comes in all shapes and sizes. Some
districts completely turn over their operations, including hiring
and firing employees, to contract management companies.
Others might limit the arrangement to purchasing. Sometimes
the management company can play only a consulting role.

"There may be some cost efficiencies associated with doing it one way
or the other, but it is really a function of what's going on in the
district," says David DeScenza, regional vice president of sales for
Compass Group's Chartwells Division, which contracts with 519 school
districts around the country.

Purchasing Efficiency

Food service management companies say they can save school
districts money through their purchasing power and other efficiencies,
freeing up funds for the classroom.

District Initiative

Critics of private-sector involvement in food operations don't dispute
that large companies can offer school districts economies of scale.


"I personally think there's no more work involved in hiring a qualified
food service director to manage the program," says Mackey, who
estimates that only five of the 303 school districts in her state employ
proprietary firms. "A qualified, capable food service director can do
everything for a school district that a management company can."

That argument worked in Ohio's 7,200-student Brunswick City
Schools, a suburban district 25 miles south of Cleveland. More than a
decade ago, the school board there hired ARA, now Aramark, to run
the district's ailing food service program. After three years, the
program still operated in the red, says Mary Grace Kenny, the district's
food service coordinator.

In 1994, the school board considered switching to another company
and possibly closing the kitchens in some schools. Some veteran
food service staff feared that a new company would eliminate
full-time positions and cut benefits to slash costs. So they
Resolved: The Baltimore City Board of School Commissioners for Baltimore City         7
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


devised a plan. The employees asked the school board to give
them a year to run the food service department. If it wasn't in
the black by then, they would agree to step aside and let the
outsiders run the show.

"We felt that since all of us lived and worked and had children and
grandchildren in the Brunswick school system that we could do a much
better job than an outside company," says Kenny, who at that time
was managing an elementary school cafeteria.

Employees made concessions to effect the change, including giving up
paid holidays and snow days. But the self-operated program broke
even in the 1994-95 school year and has operated in the black ever
since.

Now a committee of food service employees runs the department.
Kenny oversees it, filing state reports and centralizing orders. The
department makes enough money to purchase its own equipment and
pay salaries and retirement benefits…

The article also discusses the complexity of outsourcing, how companies use strategic marketing tools to
market meals, budget constraints school boards often face, wages for employees and purchasing power of
food service directors. Very comprehensive document. Successes and challenges are listed with a
response to the question: Would benefits to children and the school district be sufficient to warrant
moving the production side of our operation, primarily cooks and cashiers, to the contractor?

Check out the related article that is attached to complete article. It includes a directory of food service
firms.




Resolved: The Baltimore City Board of School Commissioners for Baltimore City                                 8
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007



http://www.usatoday.com/news/health/2005-08-21-junk-food-cover_x.htm
Health movement has school cafeterias in a food fight
By Nanci Hellmich, USA TODAY
Elizabeth Nyikako, 16, a senior at Whitney Young High School in Chicago, used
to buy a Coke or a Twix candy bar from school vending machines, but no more.
Now she gets bottled water and granola bars.


That's because last year Chicago Public Schools revamped what was offered in
the machines. Soft drinks were booted out, and water, sports drinks and juice
were offered instead. Granola bars and baked chips replaced candy bars and
fried chips.

Food for thought is taking on a new meaning as students across the nation begin
a new school year. Chicago is just one of many school districts that have
mobilized to replace high-fat, high-sugar foods and drinks with healthier choices
in vending machines and cafeteria à la carte lines. Students returning to schools
in cities such as Washington will see good-for-you foods in vending machines for
the first time this fall.

This year alone, 42 state legislatures have enacted or proposed measures that
require or recommend nutritional guidance for schools, says Carla Plaza of
Health Policy Tracking Service, which reports on state health legislation. Some
set limits for elementary and middle schools but give high schools more choices.
Others propose standards that would apply to all grades…

The supposed beneficiaries of this nutritional reform appear to have mixed
feelings. "I saw the purpose of it — to make sure kids were eating healthier food
at school," Nyikako says. "But on the other hand, I felt like people should be able
to make choices without over-indulging. One candy bar a month isn't going to kill
you."

Talbert hates the switch. "What they have to offer now, none of us want," he
says. "It's OK to be healthy every now and then, but it shouldn't be forced on us."


In fact, the rules governing school foods are fairly complex.

Traditional school breakfast and lunch programs are regulated by the U.S.
Department of Agriculture. The foods in vending machines and school stores —
sometimes called "competitive foods" because they compete with the meal
programs — are not regulated by the agency.

Because the USDA's guidelines for foods of minimal nutritional value in school à
la carte lines haven't been updated for years, it's possible to get some vitamin-
Resolved: The Baltimore City Board of School Commissioners for Baltimore City         9
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


impaired fare there. Cafeterias can sell candy bars, cookies, ice cream and
french fries but not Popsicles, lollipops and breath mints…




Resolved: The Baltimore City Board of School Commissioners for Baltimore City         10
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007




http://www.nytimes.com/2007/09/05/business/05junkfood.html

The School Cafeteria, on a Diet

… A bill sponsored by Senator Tom Harkin, Democrat of Iowa, that is
pending in Congress would authorize the Department of Agriculture to
update its rules for what could be sold at schools throughout the day.
Several previous attempts by Senator Harkin have failed because of
opposition from the food and beverage industry.

This time around, however, the American Beverage Association, which
represents the soda industry, does not oppose the bill but is trying to
iron out differences with Senator Harkin’s staff about rules on
beverages. The Snack Food Association favors guidelines rather than a
mandate.

The article goes on to discuss nutrition policies in specific states and when and where
they have not been accepted across the board. In fact, one school removed deep fryers
when their cafeteria was renovated which meant that “fried French fries” were deleted
from the menu.




http://www.cspinet.org/new/200710291.html
Groups Announce Global “Dump Soda” Campaign



An international coalition of consumer organizations announced the formation of
the Global “Dump Soda” Campaign to call attention to the marketing of sugary
soft drinks and other high calorie beverages linked to the world-wide childhood
obesity crisis.

The campaign targets “transnational giants” Coca-Cola and PepsiCo…They
outline five points that they want these companies to address. The campaign
also references third world countries that deal with obesity AND malnutrition.

The International Association of Consumer Food Organization is one of the
campaign sponsors – www.IAFO.org

Resolved: The Baltimore City Board of School Commissioners for Baltimore City             11
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


http://www.cspinet.org/new/200604052.html

Bipartisan Support on Capitol Hill for Healthier School Foods

Child Nutrition Promotion and School Lunch Protection Act Introduced

The school foods reform movement, which has been sweeping through states
and local school districts, has reached the nation’s capital. Bipartisan legislation
aimed at improving the nutritional quality of foods available in schools was
introduced today in both houses of Congress. The bill calls on the U.S.
Department of Agriculture (USDA) to update its decades-old nutrition
standards for drinks and snack foods sold in cafeterias alongside the
regular school meals and to apply those standards everywhere on school
grounds, including in vending machines and school stores.

In 1979, USDA defined what it calls “foods of minimal nutritional value,” and
restricted sale of those foods in the cafeteria during mealtimes. Since then,
however, current nutrition science has rendered those standards obsolete,
according to the Center for Science in the Public Interest (CSPI). And since so
much food is sold outside the cafeteria throughout the school day, the bill’s
sponsors say updated standards should apply to the whole campus…

Supporters of the bill argue that it is largely a myth that improving school foods
reduces school revenue. Much of the money spent on junk food in vending
machines or a la carte lines would otherwise be spent either on healthier snacks
or on the federally reimbursable school meal. Also, schools’ soft-drink vending
contracts typically raise only about $10 to $20 per student per year. In a survey
of 17 schools and school districts conducted by USDA and the Centers for
Disease Control and Prevention, 12 schools and districts increased their
revenues after switching to healthier options, and four reported no change.

“Revenue from junk-food sales isn’t a philanthropic donation by soda and snack
food companies,” Wootan said. “The money comes out of children’s pockets, and
Coke and Pepsi take a cut of that money back to corporate headquarters.
Schools, are, in effect, taxing kids to help fund schools.”

The legislation is supported by CSPI, the National PTA, the School Nutrition
Association, and more than 80 other organizations.

Check out the additional organizations that support the legislation.




Resolved: The Baltimore City Board of School Commissioners for Baltimore City         12
Public Schools should establish a policy to improve the selection of food in school
cafeterias.
Next MS Tournament – Chinquapin MS – Saturday, December 8, 2007


http://www.pta.org/archive_article_details_1127342488046.html

Healthy Lifestyles—The State of Nutrition in Schools Today

This is an overview of the status of junk food in schools. Brain development is cited in the article
as well as performance in school. Additional resources include an article that states that obesity
and bullying behaviors are related.
http://www.njpta.org/committee/nutrition.html

This is a very detailed newsletter from the New Jersey Parent Teacher Association. It includes
links to national organizations that deal with nutrition and specific wellness issues. They also
address policy issues and policy language and reference USDA as a source for further details. Be
sure to browse the “other resources” section closely. Contact information for the National Parent
Teacher Association is also provided.

Additional Resources AFF and NEG

The Center for Consumer Freedom

The Center for Consumer Freedom is a nonprofit coalition of restaurants, food
companies, and consumers working together to promote personal responsibility and
protect consumer choices.

The growing cabal of "food cops," health care enforcers, militant activists, meddling
bureaucrats, and violent radicals who think they know "what's best for you" are pushing
against our basic freedoms. We're here to push back.

Links include www.CSPIscam.com which claims that the Center for Science in the Public Interest
has no interest in the public interest, and www.obesitymyths.com which states that the
overblown rhetoric about the "obesity epidemic" has itself reached epidemic proportions,
sending the public and the media into a frenzy over the nation's waistline.




Resolved: The Baltimore City Board of School Commissioners for Baltimore City                    13
Public Schools should establish a policy to improve the selection of food in school
cafeterias.

				
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