By Kristi Willis
Photography courtesy of HISD, Bianca Bidiuc and Kate Adamick of Cook for America
The statistics are staggering and the word epidemic is bandied about frequently. According to the Centers for Disease Control and Prevention (CDC), 32 percent of high school students in Texas were overweight or obese in 2011. Obese children are more likely to have high blood pressure and high cholesterol, both risk factors for cardiovascular disease.
They are more likely to develop type 2 diabetes, breathing problems and asthma, joint problems and fatty liver disease, as well as low self-esteem and social and psychological problems. And tragically, for the first time in two centuries, today’s children may have a shorter life expectancy than their parents.
The search for a remedy has led to much finger-pointing and blame. School-food professionals have been demonized, the restaurant industry has been vilified and parents have been shamed about the contents of their pantries. One thing is certain: the solution is complex and requires comprehensive change. At the Healthy Flavors, Healthy Kids conference hosted at the Culinary Institute of America’s San Antonio campus last spring, nutrition writer and teacher Sanna Delmonico reminded a room full of educators, school-lunch professionals and nutritionists that making changes in America’s food culture will take time. “We’re talking about changing our culture, not just changing our food. It takes a long time to see results, just as it took a long time to get to the place we are today.”
While many have been working on the problem for years, First Lady Michelle Obama brought national focus to the issue through her Let’s Move! campaign, an initiative launched in 2010 to help children and families make healthy choices around diet and exercise. From the beginning, it was clear that people were ready to take on the challenge. “The country’s response to the initiative has been overwhelming and showed us that people are ready to get involved and be agents for positive change,” says Marissa N. Duswalt, associate director of policy and events for Let’s Move! “We’ve seen everyone from CEOs to pastors to parents take action to champion our children’s health, from improving healthy menu and grocery choices to growing gardens to walking more as a family.”
One of the program’s first targets was making healthful food more available at school. The National School Lunch Program, which serves meals to over 31 million children daily, provides the greatest opportunity to introduce healthful food to a majority of children. The Let’s Move! campaign worked with other coalition partners to make vast changes to the program in the Healthy, Hunger-Free Kids Act of 2010. The new legislation requires that schools change the meals they serve to include more fruits, vegetables and whole grains by the fall of 2012. Currently, schools are required to offer fruits and vegetables as two separate components of each meal and to limit the quantity of starchy vegetables, like french fries or mashed potatoes, throughout the week. Whole grains must be used for at least half of the grain-based products and only whole grains will be used by 2014. In addition, meals can no longer contain trans fats and sodium content will gradually be reduced over the next 10 years. In some districts, the new rules seemed drastic and caused panic about meeting the mandate without busting budgets. There was also concern about getting the kids to accept the new foods. But other schools were prepared for the new law—having started the conversation about how to get more fresh food on the plate years before.
Chef Kate Adamick, cofounder of Cook for America, works with districts across the country to assess existing food-service operations and create plans to incorporate more from-scratch cooking into menus. Armed with the motto: “School food is the solution, not the problem,” Adamick looks for opportunities to create economies of scale and more efficiently use the existing resources of the district. “Kitchens are often busy from six a.m. to one or two p.m., Monday through Friday,” says Adamick. “That isn’t necessarily the most efficient way to use the kitchen. Sometimes it works better to have some of the employees come in later in the day—like right before lunch service—to help serve and then do prep into the afternoon. You have fewer people working in the kitchen and, if you have limited oven space, you can stretch out the time ovens are available.” Ultimately, Adamick sees school-food professionals as teachers and believes their role is an extension of the classroom. “Kids don’t stop learning just because they walked into the cafeteria,” she says. During Cook for America’s Lunch Teachers Culinary Boot Camp, school-food professionals receive the same kind of culinary training as chefs—giving them the ability to creatively approach their menus and maximize the available resources.
In California, the department of public health has teamed up with schools to introduce in-season fruits and vegetables to kids through the Harvest of the Month program. Each month, a new fruit and vegetable are introduced to the cafeteria menu, as well as in the classroom, where kids learn about the nutritional value, history and culture of the produce. Parents receive a newsletter with nutritional information and a recipe, while teachers also receive tips on taste-testing the produce in the classroom and ideas for student activities. In addition, a community newsletter is available to retail stores to help reinforce the learning and promote the produce in grocery-store aisles. Delmonico cites the program as a great success at helping kids and families adopt new foods into their diets. “Having the food introduced in the classroom made the kids much more likely to take it at lunch because it wasn’t brand-new anymore. And, if they see that same food at home and their parents are eating it, they’re even more likely to accept it.”
Helping districts across the country find ways to bring more fresh, local produce into the kitchens is the mission of School Food Focus, a collaborative of over 30 large school districts that includes the Austin, Houston and Dallas Independent School Districts. By providing technical assistance and collaboration tools, School Food FOCUS works with schools to identify partners in their area with whom they can build long-term relationships. For example, the program recently partnered with Chicago Public Schools—where the growing season doesn’t coincide with the school year—to find a way to preserve locally grown produce so that it could be used throughout the school year. Utilizing a defunct frozen-vegetable processing plant in the area, the team was able to flash-freeze fresh vegetables for school-meal enjoyment year-round.
Also in Chicago, the district was struggling to find a cost-effective solution to replacing processed chicken nuggets with whole-muscle chicken. Using School Food FOCUS’s Learning Lab, the district was able to find not one, but two suppliers. The first supplier was a local producer who was selling organic chicken to a national retailer who wanted everything but the drumsticks. The farmer now sells the drumsticks directly to the Chicago Public Schools.
The second supplier was a conventional producer who was selling dark meat, like legs and thighs, overseas because they didn’t have a domestic market for the less popular cuts. Not only did the Chicago schools start ordering from the supplier, but they worked with USDA Foods to add the supplier to their national list so that any school in the country could order the chicken.
In St. Paul, Minnesota, schools wanted flavored milk with a lower sugar content, and worked with School Food FOCUS to develop a request for proposals for a new milk product. Their current vendor was more than happy to provide the lower-sugar milk, and also made it available to any other district in their customer base. All it took was letting the supplier know there was a desire. Sheilah Davidson, the policy program manager and stakeholder liaison for School Food FOCUS, explains that their work is about giving school-food professionals the tools and partnerships they need to solve problems creatively. “The folks we work with are very solution oriented,” says Davidson. “We help them to share information with each other so that they aren’t having to reinvent the wheel all over the country.”
FARM TO LUNCH TRAY
In Central Texas, School Food FOCUS helped the Austin Independent School District (AISD) and the Sustainable Food Center (SFC) partner to create Farm to School—a program that brings food from local farms into cafeterias and reinforces its importance with hands-on classroom and after-school training about gardening, cooking and healthful-food concepts. Local foods are identified in the cafeteria line, and “meet the farmer” activities bring local growers into the schools for face-to-face interaction. The pilot program worked with six schools. After an evaluation with the University of Texas School of Public Health, it was enhanced further at the predominantly lower-income schools to include parent-led wellness teams to reinforce the importance of healthful foods at home.
This enhanced program added targeted outreach to parents to get them engaged in SFC’s cooking and gardening classes and to promote the farmers markets. Recognizing that one aspect was still missing from the wellness equation, though, the program was expanded once again to include a partnership with Marathon Kids, a local nonprofit that focuses on children’s fitness, and the creation of parent-led school wellness teams. Parent teams assess what works best at their individual schools and ask SFC and Marathon Kids to help them implement changes. The wellness teams have begun taking on more of the leadership role and the full-service program has morphed into Cultivating Healthy Communities. SFC currently works with 22 primarily lower-income schools through Cultivating Healthy Communities, and almost 30 schools through Farm to School, to incorporate local food into their cafeteria menus.
IT TAKES A VILLAGE
In addition to the Farm to School and Cultivating Healthy Communities programs, AISD has embraced a comprehensive wellness agenda that not only revamps school food, but also includes a health and wellness focus for all faculty and staff. Based on the CDC’s coordinated school health model, the wellness program targets eight key areas: health education, physical education and activity, nutrition services, environmental health, staff wellness, mental and behavioral health, health services and parent and community involvement. “The benefits we are hoping to see are students and staff making the healthy choice the easy choice, and that translating to their home and community environments,” says Tracy Diggs Lunoff, administrative supervisor of health services at AISD. From removing the junk food in vending machines to adding Weight Watchers points to school menus, the focus on health and well-being is evident throughout the schools. In the classroom, teachers work with kids on how to make good food choices using the Texas Education Agency’s food-scoring concept, Go, Slow, Whoa, which teaches kids which foods are okay to eat any time, those that should be eaten less often and those to be eaten sparingly or not at all. The concept is reinforced in the cafeteria and also taught to parents.
For the Houston Independent School District (HISD), the focus has been on reducing processed food, improving participation rates in eating school meals in high schools through fresher, build-your-own menu options and implementing breakfast in elementary and middle schools to help kids start the day off right. “Overwhelmingly, our First Class Breakfast program has had the biggest impact on student health,” says Brian Giles, senior administrator of food services at HISD. “National studies show students who eat healthy school breakfasts each day make more nutritious meal choices throughout the day. Eating nutrient-dense school breakfasts will help satisfy midmorning hunger pangs, provide students’ energy needs for the morning classroom day and help students avoid overeating throughout the remainder of the day.”
Even the most successful programs face hurdles. Bettina Elias Siegel, food advocate and author of The Lunch Tray blog, shared that early on in HISD’s breakfast program, they tried to introduce oatmeal and the kids wouldn’t eat it. “Unfortunately, oatmeal was not a common part of the diet for many of the kids, so the program tanked,” says Siegel. “Kids weren’t familiar with it and it didn’t look appealing.” The district went back to the drawing board to find more palatable options and also started introducing foods in the classroom before they showed up on the breakfast tray.
SFC also ran into problems when they expanded their Farm to School program because farmers didn’t have the capacity to deliver to 18 or more campuses. As the program grew, they turned to a local distributor, Farm to Table, to help with fulfillment. These types of challenges also occur when trying to apply a solution across districts. Unique resources and regulations in each area mean that an innovative solution in one place won’t necessarily work in another. Things like state reimbursement rates, funds from school foundations and the number of students who pay for lunch make a significant difference in the success of reform programs.
“When you see a success story, people often ask why that isn’t happening in their district. You really have to look at all the moving parts,” explains Siegel. “School food is incredibly complex. There are so many different factors: labor costs, are campuses open or closed, how affluent is the community, do the schools have facilities for cooking, is there outside funding supporting that effort? There is no one-size-fits-all answer.”
MODELING GOOD HEALTH AT HOME
To integrate healthful choices as an ongoing habit, children need to see and hear the same messages at home. Delmonico reminds parents that kids watch their actions and do what they see. “You can’t expect kids to eat better than we do,” she cautions. “You can’t expect them to eat breakfast if you aren’t. You can’t expect them to try new things if you won’t.” Delmonico recommends that parents not put pressure on kids, as that usually backfires, and instead, make foods emotionally neutral. “There is this assumption by parents that kids aren’t going to like vegetables and are going to like sweets,” says Delmonico. “When we make that assumption, we set them up to anticipate that something isn’t going to taste good. The goal is to make all food emotionally equal. There are some different health considerations around eggplant versus fudge, but emotionally they are the same. Prepared well, they can both be delicious.”
Duswalt encourages families involved in the Let’s Move! program to remember three keys as they build healthful habits. First, start small. For example, start by serving juice mixed with water to cut down on the sugar, and then transition to just drinking water. Improving a child’s health and nutrition is about practicing simple, healthful habits regularly in order to instill them over a lifetime. Next, involve the family. Model healthful choices and make those choices easy at home, for example by keeping fruit out where kids can easily see and reach it. And finally, don’t give up! Small changes like taking a family walk or letting your child pick out a new vegetable for dinner are hard at first, but they add up over time. If something doesn’t seem to work the first time, keep trying. You’ll land on the right ideas to make nutritious food and an active lifestyle the norm for the family.
Lisa Leake, mom and blogger at 100 Days of Real Food, decided to adopt a diet that didn’t include processed foods after reading Michael Pollan’s book In Defense of Food. She wanted to change everything overnight, but her husband preferred a slower approach to overhauling the family pantry. “It can take months, even years, to see transformation in diet,” says Leake. “You have to be persistent, without being overbearing. You don’t want huge conflict at the dinner table, but you have to keep trying different ways of preparing things.” When presenting new foods, Leake often starts with a kid-friendly preparation like whole-wheat zucchini bread as a way to introduce the squash. If the kids like that, then she’ll make sautéed or roasted squash the next time. She also suggests involving kids in dinner and their food choices. Having them help with the shopping, picking recipes and cooking together are easy ways to pique their interest in food.
Helping this generation of kids live healthy lives will require changes at school and home and support for comprehensive, community-driven programs, the results of which will bring wellness to lunch trays and family tables across the nation and pay off in ways more significant than a reduced waistline.
Austin Independent School District Wellness Initiative
The Lunch Tray
Sustainable Food Center
2012 HEALTHY FLAVORS, HEALTHY KIDS
RECIPES COURTESY OF CULINARY INSTITUTE OF AMERICA
ROASTED BEET SALAD WITH BLUEBERRY VINAIGRETTE
For the vinaigrette:
1 T. finely diced shallot
½ c. blueberry vinegar
1 t. finely chopped fresh thyme
Juice of 1 lemon
1 c. extra-virgin olive oil
Salt and pepper, to taste
Sugar, to taste
For the salad:
1 celery root, sliced paper-thin
4 bunches baby golden beets, roasted, peeled and cut into halves or quarters
4 bunches baby Chioggia beets, roasted, peeled and cut into halves or quarters
3 oranges, peeled and segmented
1/2 c. blueberries
1/2 c. chervil leaves
4 bunches baby red beets, roasted, peeled and cut into halves or quarters
2 T. candied orange zest
In a glass bowl, mix the shallots with the blueberry vinegar. Let sit for 10 minutes. Add the thyme and
lemon juice. Slowly whisk in the olive oil. Season with salt and pepper and sugar.
Toss the sliced celery root with just enough vinaigrette to lightly coat each piece. Season with salt and pepper and let sit for 10 minutes.
Combine the golden and chiogga beets, orange segments, blueberries and chervil. Add the red beets at the last minute. Mix with vinaigrette.
To serve, place the thinly sliced celery root on a serving plate, overlapping the pieces, until the plate is completely covered in a thin layer. Place a small mound of the beet mixture in the center. Drizzle the celery root with a bit of the vinaigrette. Garnish with candied orange zest.
DINOSAUR KALE AND SWEET POTATO SOUP WITH OLIVE OIL AND TOMATOES
Makes 2 quarts
¼ c. extra-virgin olive oil or canola oil
10 oz. onion, diced
5 oz. carrot, diced
5 oz. celery, diced
1 bay leaf
½ t. dried oregano
½ t. dried basil
10 oz. sweet potato, peeled and diced
10 oz. tomato, chopped
6 c. vegetable stock
4 oz. kale, chopped
6 oz. cooked farro
¼ c. extra-virgin olive oil
1½ t. kosher salt
½ t. black pepper
In a large pot, add the first ¼ cup of olive or canola oil and cook the onion, carrot, celery, bay leaf and dried herbs for 10 minutes over medium heat, or until the vegetables start to brown. Add the sweet potatoes and cook another 5 minutes, stirring to prevent burning. Add the tomatoes and cook another 4 minutes, then add the stock and kale and bring to a simmer. Cook for 20 minutes. Stir in the cooked farro and the olive oil, salt and pepper.
BROCCOLI WITH GARLIC OIL
4 c. broccoli, cut into bite-size pieces
2 t. olive or canola oil
1½ T. finely minced garlic
¼ t. salt
Ice water, to chill as needed
Bring a 2-quart pot of water to a rapid boil. Add the broccoli, return to a simmer and cook for 2 minutes. Drain and let the broccoli cool in the ice water. In a skillet, heat the oil over medium heat and add the garlic. Cook for 30 seconds, taking care not to brown it. Add the broccoli and toss in the garlic oil; season with the salt.