LIMA — Want to cut childhood obesity? Don Horstman says he can do it right now.
“Outlaw fast food, junk food and candy,” the Kalida superintendent said only half-jokingly.
The suggestion never will happen, but his point is shared by other school officials who say the problem can’t be fixed solely by schools and that it’s unfair to ask them to try.
“Children come to us in the morning, but there is nothing stopping them from stopping by the convenience store and picking up a Mountain Dew and doughnut for breakfast. And there is nothing stopping them at the end of the day from doing that same thing,” Horstman said.
Then let’s talk about parent responsibility.
“They go home and pull Hot Pockets and a Pepsi out of the fridge,” Horstman continued. “I don’t care what we serve in the school or how much exercise we get them, we can’t offset that.”
Ohio Gov. Ted Strickland signed into law Healthy Choices for Healthy Children, legislation designed to combat childhood obesity by asking schools to serve healthier food, increase physical activity and keep track of Body Mass Index (BMI).
One in three children born in Ohio is overweight by the third grade, Strickland said. For the first time, life expectancies for children are declining, said Becky Dershem, director of nursing at the Allen County Health Department.
“It has clearly been proven that we are raising a generation of children who are apt not to live as long as their parents,” she said. “That is because we have developed these unhealthy food habits, these unhealthy lifestyles.”
The 2009 Allen County Health Risk and Community Needs Assessment classified 15 percent of Allen County children as obese. Seventeen percent were overweight. State and national numbers of obese children are 12 percent and 13 percent, respectively.
The Ohio Health Department periodically records BMI of third-graders. The last one, in the 2004-05 school year, showed 35.1 percent were overweight or at risk of being overweight in Allen County. Those who were overweight were at 22.8 percent.
Percentages in the region were Auglaize, 46.0 and 31.2 percent; Hardin, 38.7 and 26.2 percent; Putnam, 50.1 and 29.7 percent; Van Wert, 30.8 and 20.2 percent.
“Go to a swimming pool or any public gathering place and look at the children and see how many you think are overweight,” Dershem said.
Childhood obesity leaves children at risk of developing diabetes, heart disease, lung disease and joint destruction, Dershem said. When school nurse Kate Morman came to Lima schools six years ago, a couple schools had pupils with diabetes. Now every school has multiple cases.
“We’ve seen a real increase in juvenile diabetes, and that coincides directly with childhood obesity,” she said.
Morman, now the district’s team leader, suspects nearly 50 percent of students are considered overweight. If healthy eating and exercise aren’t addressed early on, those kindergarten and first-graders bordering overweight are likely end up obese, she said.
“I definitely think school has to play a bigger role, yet it is a big responsibility. There are so many factors,” she said.
The new law focuses on schools offering healthier ala carte and vending food and beverage options. Many school officials say they meet the requirement.
Lima schools’ ala carte items must contain less than 35 percent sugar by weight or less than eight grams of fat, said food service director Carrie Woodruff. Examples are baked chips and 1-ounce cookies as opposed to 1.5 ounces.
Along with salads, yogurt, whole grain soft pretzels and fresh fruit, Shawnee middle and high school students can still get french fries off the ala carte menu two days a week. They are on the regular menu once a month, but some complain the option is there at all, Superintendent Paul Nardini said. He hears the same about pizza.
“They say if we didn’t offer it, they would be forced to eat healthier, but I’m not sure they would eat at all, or they would bring something from home,” he said.
Schools make sure pupils drink healthier. Soda machines are long gone, sugary items replaced by more water and beverages with fewer calorie.
Many schools still offer chocolate and other flavored milks. Shawnee cafeteria director Sally Allen is considering moving from 2 percent white milk to skim milk. She can’t serve 1 percent because the state says white milk must have two different fat contents. Skim would qualify.
“I don’t know how accepting that would be, especially to the younger kids,” she said.
Much is in the news about children eating healthier, including first lady Michelle Obama’s goal to “bend the curve” of today's child obesity rate — almost 20 percent — back to its 1972 level of 5 percent by 2030.
Chef Jamie Oliver got involved, trying to change eating habits and school lunches in Huntington, W.Va., a place deemed one of the unhealthiest in the country. Oliver’s efforts were televised weekly.
School officials here, like in Huntington, said it is sometimes out of their hands. Schools in the National School Lunch program get government commodity food. Commodity items — things such as chicken nuggets and hotdogs — aren’t always the healthiest choices available. Fresh fruits and vegetables are never in the delivery truck.
“If they could make changes there and offer us more, then that could be one place where we could help on the actual school lunch tray,” Woodruff said.
Schools can’t afford not to use subsidized items, Horstman said. Kalida lost money in the cafeteria three straight years up until last year. Officials liken cafeterias to businesses needing to make money. If they don’t, districts’ general funds suffer.
Officials can’t imagine not serving nuggets, hot dogs and pizza.
“At the elementary school, everybody and their brother eat those days,” Horstman said.
“It is a double-edged sword,” Nardini said. “You can just have healthy food, but then you take a beating in the cafeteria. You would be operating in the red all the time if you didn’t offer things kids liked.”
Schools largely purchase ala carte items from vendors, some that are better than others at offering healthy options. Lima schools offer fruit roll-ups, but to meet the district’s nutritional requirements, options are slim. Most have at least 50 percent sugar.
Manufacturers are doing better, Woodruff said, coming out with whole grain items and fewer calorie snacks.
Eighty-five percent of Lima schools pupils eat school lunches, a little higher than most. For the most part, school meals are healthier than what pupils bring from home.
There aren’t a lot of fruits and vegetables in those lunch boxes, but instead potato chips and sweet treats. Prepackaged snack kits like Lunchables are the worst.
“They are so high in sodium, but they are convenient,” Allen said. “And then they throw in a bag of chips and a Little Debbie snack.”
Some students are taking it upon themselves to eat better. Allen doesn’t serve nearly as many fries as she used to.
“There are still those kids who want the fries, the greasiest things, but there are a lot of kids out there that are really being more careful with their choices,” she said.
The bill requires BMI screenings for pupils entering school and the third, fifth and ninth grades.
Debate over the issue led to a parental opt-out and waiver options for schools unable to comply. Minster schools will request a waiver, but Superintendent Gayle Ray wonders how long it can keep applying for one.
Determining body mass involves measuring weight and height and putting them into an equation. It will take time, including classroom learning time. County health departments will help some districts.
Doing screenings during the school day means losing classroom time, Horstman said. Collecting and reporting data means more work, he said.
Finding time will be an issue, too. Buildings often share nurses who already are overwhelmed with duties, Lima schools Assistant Superintendent Jill Ackerman said.
Lima schools talked about screenings before. Officials wonder what the point is unless they also can provide helpful information to parents.
“If there is an issue, then we need to be prepared to have some educational pieces for parents to talk about what you can do if your child has a high BMI,” Ackerman said.
Morman sometimes sends information home about a child’s weight, but it can be a sensitive topic. There often are other weight issues in the family. And places she might refer families to for help cost money.
Increased physical activity
The bill also establishes a voluntary pilot program to encourage 30 minutes of daily physical activity. Recess cannot be included. Participating districts get recognition on their state report cards, although it won’t affect the designation.
This is the portion that school districts and education groups lobbied most against. Nardini can’t believe any district will do it because of time constraints and costs.
“It really would have been a financial drain on the system and one of those unfunded mandates,” Nardini said.
Many would need to hire additional teachers. Gym space also would be an issue at Minster schools, Ray said. Officials questioned how students would find the extra time.
“If it is during the day, then OK, what do we get rid of?” Ray said. “What do you want to go?”
Scheduling becomes even more difficult for high school students taking post-secondary and dual enrollment classes, Horstman said.
Adding 30 minutes would be a huge change. Middle school pupils usually take a semester of physical education a year. Elementary pupils get a period or two a week.
Ackerman said the Lima school district has incorporated more physical activities into the day, including in between classes and with events like walk-a-thons. It won’t do the state program.
“I think we have been pushed about as far as we can go right now, with time especially,” she said.
A societal issue
The Lima district has done things to promote healthier lifestyles with pupils and staff. It seeks grants to bring in fruits and vegetables, and it holds health fairs and health education programs. Schools have a responsibility, Ackerman said, but it can’t fall just on them.
“I think it does make a difference, but can we reach and touch everybody? I don’t know that we can,” she said.
Society as a whole needs to address what people eat if efforts in the schools will have an impact, Ackerman said.
“When you walk into a grocery store, it is much cheaper to buy processed foods that are high in fat and sugar and everything else than to make a healthy choice,” she said. “Our families will buy what they can afford in this economy. It needs to be a society change in way of life, not just something different you are doing in schools.”
It goes far beyond diet, officials said, suggesting more physical activity at school can’t combat a generation that spends more time in front of a television or computer screen than past generations did.
“I think the largest piece of the puzzle that is missing is the activity level,” Morman said. “They sit inside and watch TV and play video games.”
“You don’t see kids out playing anymore,” Nardini said. “We used to have to make our own ball fields, mow and create backstops. Now kids have all these facilities available to them, and you go by them and here is no one there.”