Childhood Nutrition ~ From Preventing Malnutrition to Preventing Obesity

In my opinion, childhood obesity is THE single health issue of our day.  If for no other reason, but because obesity is so darned difficult to reverse.  In Utopia, all children are raised in loving environments, taught the wisdom of the world, and when they reach adulthood have equal footing to make their way in this world.  Now that's Utopia, but I think we can strive for as many children as possible to reach adulthood in a position to put their best individual foot forward.

I'm a child of the 60's.  My parents were born and raised in the Depression and WWII.  I believe this influenced not only how they parented, but how this generation formed policies based on their priorities.  Nutritional guidelines, RDA's and all such related things were born out of efforts to prevent malnutrition and disease.  Diseases of deficiencies were real "in their day" and in the true form of forging a better life for one's children, this was a priority for them.    A lot of research capital was spent to determine the nutritional needs of children, and childhood obesity was quite rare.  This is not to diminish the plight of those rare cases, but public policy always targets the majority potentially impacted.  Also, at that time a fat child was more likely to be considered healthy than a scrawny one.  My how times have changed.

When I was in grade school, our school participated in a voluntary milk program.  For a nickel we got a small container of milk each day -- usually midmorning at least in the younger grades.  We didn't drink milk in our house (Mom did use it in recipes and warm cereals, we just didn't drink it by the glass),  but my parents enrolled us kids, probably more not to make us feel left out.  I also believe one could get this milk for free if one qualified.  In my grade school there was no school lunch program, there probably was not much need as this was before property taxes exploded disproportionately -- so there were few if any living in the community who could not afford the, then, smack dab middle of the middle class homes that made up the vast majority.  School lunch programs developed during my lifetime.  

First there were subsidized lunches and/or lunches provided to the needy.  But those kids who partook were subjected to teasing, stigma, etc.   Apparently, the parents could not be trusted to spend individual aid on lunches for their kids to bring to school so the idea was to bring the nutrition directly to the children.  Noble ... but we can see the slippery slope we've long since slid down to where we are today.  My generation was the pre-self-esteem generation.  Teachers didn't worry over hurting our feelings with too much red ink on a page, though at least in the lower grades we still got gold stars or fun stamps on our exceptional work.    We had advanced and remedial classes.  Kids with speech impediments had therapy, etc.etc.  School was for education, not social engineering.  Parents were responsible for feeding their children, and I'm sure there were cases where the parents struggled where they sought out resources to assist them.  This was, after all, the purpose of food stamps and programs like WIC, etc.

Look, human beings almost never do everything for themselves.  We enter into contracts with one another to divvy up labor and such.  Bartering being rather less efficient, particularly on larger scales, currency allows for easier transactions.   I know this much about things one does not pay for:

1. You get what you pay for is a sound cliche, and 
2. You tend to care about and fight for value in goods and services you do pay for because on some level you are assessing that value to you based on what you earn for whatever you do for a living.  

I believe school lunch programs were well intentioned.  But the answer to dealing with stigmatization of those using the programs is to find more discrete ways of delivering the services to those truly in need, while many school systems merely adopted universal school lunches.  

Now my memory is fuzzy, but there was no talk at all about breakfasts when I was a kid.  And I wonder if those studies that came out some time in the 80's or 90's aren't at least partly responsible for this obesity epidemic.  Breakfast was not "the most important meal of the day" when I was a kid.  These studies too, seemed to evolve out of truly malnourished cases.  IOW, there's a big difference between a kid who wakes up late and/or just skips breakfast and a kid who was hungry but sent to school without breakfast because their parents couldn't afford it.  As food was now provided in many cases at lunch, there were probably more than a few households where things were tight where they counted on that lunch to be breakfast and lunch.  And now many schools provide breakfasts as well, and I've seen talk of dinners too.  

In any case, we now have edicts from on high as to what qualifies to be sufficient nutrition, which morphed to required nutrition.  And now we're at a point of limiting nutrition in the schools, because the pendulum has long since swung from the side of a safety net against malnutrition to controlling matters to stem obesity.  And it's a one size fits all approach that comes down from on higher still, and all the more misguided and inefficient.  My brother was not much older than me but ate a ton more than me for as long as I can remember.  The only things we received equal amounts of were treats, although on the occasion we got pizza (a real treat for me!) he got an extra half-to-full slice.  Waaahh, no fair!!  You have ridiculous stories coming out seemingly every day -- lunches brought from home taken away, bans on certain foods that can be brought from home, limiting food available in vending machines, limits on portions.  This is not the schools, but in a city where many are cheering Nanny Bloomberg's soda downsizing, he's also essentially banned "home cooking" in shelters because the nutritional content (especially transfat and salt contents) of foods cooked from scratch cannot be verified.  That is INsane!  

So what prompted me to jump the gun on following up on the School Lunch Survey (come on over and participate!) were a pair of competing takes on the fall-out over the new guidelines, in addition to the Moms' complaints from my prior post.  Let's start with one of those complaints -- one child left behind?  Annie, whose toddlers eat more than 750-850 cals for lunch (after eating at least three eggs routinely for breakfast) tells the tale of an older boy at the school she used to teach at.  This boy slept through most of the school day except for lunch -- from which she and a fellow teacher concluded he likely had a disturbed homelife where he felt too unsafe to sleep, and this was likely his only hot meal of the day.  I would say that if this were the case, NO school lunch program fixes it.   One of the problems with such programs is that one-size-fits-all is what ends up being the best -- though totally inadequate -- approach.  What are the alternatives.  Allow just this boy to get more -- then what of the jocks?  How about if Johnny walks several miles to and from school ... should he get as much as the jocks?  Then you'll have someone arbitrarily deciding that slightly pudgy trombone player Joe should get less than Suzie field hockey.  And what if you do individualize calories -- how to dispense that?  Different vouchers?  What if one kid is not hungry for all of their food one day, while their friend skipped breakfast because they woke up late and will gladly take the second sandwich.  Will there be a food patrol?  I was very active in high school, an all season varsity athlete and then some on the side.  Yet I pudged up a bit when I started eating large lunches of 850 cals at Burger King instead of lunch brought from home.  

Speaking of athletes, FTA Mom Sadie sue, was complaining how her oldest daughter would not be able to make it through 2.5 hours of volleyball practice on that level of lunch calories -- only the lunch she described was hardly anything close, which I'll address in a moment.  But lunch is not necessarily supposed to sustain an athlete.  Bring more food from home -- a banana and nut-butter perhaps?   We ate around noon and practiced often at 3:30.  Frankly I wasn't hungry before and would feel weighed down if I ate a snack.  Where's all this fat burning glory when you need it anyway?!  I don't recall most of my teammates eating anything between lunch and practice either, and often times lunch was more on the order of 400 cals or so.  The coach sometimes provided orange wedges, or we'd bring a snack for (after) away games and the bus ride home. 

Which brings me to Tom Naughton's blog post on some school lunch protests which cites this news piece:

... Protesters in Kansas and elsewhere say 850 calories isn’t enough for some high-schoolers, particularly athletes who can burn calories by the thousands. ...

They made a parody video that:  

... shows students staring woefully at lunch trays, stuffing lockers with junk food, collapsing during volleyball practice and crawling on the ground in exhaustion.  

Here are the lyrics:

Give me some seconds, I,I need to get some food todayMy friends are at the corner storeGetting junk so they don’t waste away

Ummmm ... am I the only one who hears this and doesn't go into a rage against the USDA, Michele Obama and Big Food?  If these teens aren't given their lunch in school, of course they have to get junk so as not to waste away?  This is utter nonsense.  First of all, if you're doing farm work or serious labor at home, your sustenance for that activity should be obtained at home.  Secondly, why is the alternative to school/government provided food necessarily junk to these people?  If they can buy and bring junk, they can buy and bring nutritious food.  Quitchyerbitchin!!  But then the article goes on to describe the lunch: 

... The lunch included one cheese-stuffed bread stick, a small dollop of marinara sauce, three apple slices and some raw spinach. Kirkham [a teacher] supplemented the lunch with items from a salad bar, including cubes of ham, bacon bits and dressing, which were available only to teachers. “I asked why the sauce had no meat and I was informed that due to the breadsticks containing cheese, the meat would put us over the guidelines for protein,” Kirkham wrote.

“Now think of a high school boy who works out at least three hours a day, not including farm work. … I’m furious. The ‘cheese’ inside the breadstick is approximately three bites. This is ridiculous.”

The basic lunch included raw spinach that students couldn't add some stuff too (dressing?!) from the salad bar?  But let's add up the calories for this supposed sample lunch.  A cheese stuffed breadstick with approximately 3 bites of cheese.  Let's give that a generous 2oz serving size = 200 cals, 150 cals for the bread (also likely a generous estimate), and 50 cals for the apple slices and spinach.  We're at 400 calories, likely closer to 300 calories.  Even supplementing, unless Kirkham drowns her salads a la Jimmy Moore, we're likely talking no more than 200 cals likely less, but we're led to believe this isn't available to the students.  That lunch does not match the calorie limits.  So either people are getting whipped into a fury based on false claims (like that never happens, right?), or the calorie limits/suggestions aren't being followed. Sadie sue told us her oldest (11 or 12) was fed a mere two chicken nuggets, small cup of peaches and some mushy green beans her daughter didn't eat.  Yes, that is indeed insufficient, but it's also not consistent with the caloric guidelines -- I can only assume she's encouraging her daughters to avoid any grains that might be part of that lunch.  I'm sympathetic to that ... a topic for another day ... but to use a partial lunch to portray a picture of starvation is not exactly an honest debate.

Look 800 calories is a lot of food.  This is the point made by Yoni Freedhoff when he weighed in on House Republicans seeking to overturn limits.  

If they're in kindergarten through fifth grade they'd be stuck with a paltry 650 calories a meal; sixth through eighth grade - 700 calories; and ninth grade and up 800 calories.

The horror!

But wait, 650 calories is more calories than I have for lunch.

Yoni looks to be a somewhat tall man shown running (read: active) in his profile pic.  Now granted growing children in general, and teenagers in particular, do tend to need/utilize more calories per pound than adults, but their caloric needs seem to be way overestimated to me in general.  Depending on how you source those calories, 500 calories is quite a lot of food!  One can make a substantial turkey, ham or roast beef sandwich with cheese lettuce and tomato for that.  Indeed most of Subway's 6" sandwiches come in under that, most would even make it under the 800 calories for a foot long!

Also, can someone please tell me whether exercise burns a lot of calories or not?  I tend to agree with the side and the science that demonstrates -- not so much.  I didn't count calories as a kid, and I'm quite sure Mom didn't either, but I know what 500 cals looks like and I know I probably ate at most that much most meals at home and I was extremely active.  I was also lean but didn't run around with gnawing hunger either.   I think Reps are responding to the complaints being heralded by Naughton and made by folks like Sadie sue likening 6-800 calories for ONE meal to some sort of starvation.  This is absurd.  It seems this central planning is here to stay ... if I had my druthers it would just be abolished and replaced with a soup, sandwich and salad bar with a fruit basket at the end.  Give the kid a debit card of sorts and subsidize the truly needy.  Done and get over it.   But otherwise, trying to police against overeating is misguided and can legitimately harm those with higher caloric needs.  So as an alternative, provide a basic 500-600 calorie meal of "normal" proportions of 15-20% protein, 40-55% carb, and 30-40% fat to all.  This really should be more than sufficient base and no kid is going hungry on that.  We have other programs to provide food for the household in need, and the role of school lunch programs should not -- because it CANNOT -- be a surrogate for such.  

One meal per day cannot provide 100% of anyone's nutritional needs nor will it dictate anyone's dietary intake.  It goes both ways.   Dietary habits can be influenced by one institutional meal, but they are still more likely to be influenced by the dietary habits and beliefs of the parents.  My own parents would have sent me to school with a lunch every day if I grew up on the 90's.  But is there policing so that I could not have also gotten a lunch to eat the fries or whatever that tripped my fancy for stuff I couldn't get at home?  

I am passionate about preventing childhood obesity because there's nothing more sad to me than to have to deal with this for one's entire life -- to never know what not being obese is like.  Clearly this is influenced by environment in most cases and I'm sorry, but I can't get past my personal experience-based opinion that where children are concerned in this modern world, access is a huge problem.  No, I'm not ignoring the relatively rare genetic/inherent propensity towards obesity.  That is clearly real, and I've known enough kids in my life to see that the types of foods kids are exposed to can have widely varying impacts on weights.   Still, the biggest difference I see nowadays where kids are concerned is greater access to potentially problematic foods and lesser parental involvement in dictating diet.

Let me ask you this.  If school lunches were magically converted tomorrow to exactly what you would want your child to be fed ... do you think this impacts the childhood obesity epidemic?

Read more here: http://www.mcclatchydc.com/2012/09/24/169497/school-lunch-calorie-limits-leave.html#storylink=cpy