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Health Policy Analysis

Statement of issue:  School meals are required to meet specific nutrition standards to operate the school meal programs. However, meat served in U.S. schools wouldn’t meet the quality or safety standards of fast-food restaurants. In addition, a vast majority of vegetables being consumed by the children as French fries. Even though there have been some improvements in school meal programs, we have a long way to go. With the childhood diabetes and obesity on the rise, necessity for a change in how children eat is obvious. As Dr. O.Robbins says, “As long as tens of millions of families depend on school meals for a fundamental part of daily nutrition, we all have a stake in making them healthier”.

  • As of 2019, for US children and adolescents aged 2-19 years the prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents.
  • Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds. Childhood obesity is also more common among certain populations, usually of lower socioeconomic status, – thus, those depending on school lunches to feed their children.
  • Overall unadjusted estimated incidence rates of type 1 diabetes amongst adolescents increased by 1.4% annually 

Funding: For the 2016–2017 school year, schools are reimbursed by the federal government $3.22 per free lunch served, $2.82 per reduced-priced lunch, and 36 cents per “paid” lunch. The $3.22 must cover the food, as well as any labor, equipment, electricity, and other costs. Tight budget makes serving children healthy foods challenging.

Unhealthy school vendors: National School lunch Program favors larger food providers/corporate farms  when it comes to financing food for schools because they deliver better numbers, even though they sacrifice nutrition density in favor of ease of production and cost effectiveness. School lunch program has become dominated by a few large food contractors designed to feed a population suffering from a lack of resources, without catering to its basic health needs. Left unaddressed, the situation will continue to contribute to childhood obesity and associated comorbidities and yield a sicker population with chronic illnesses since young age.

The school milk Program: One thing that is given to all children, regardless to whether their school participates in federal service meal programs, is cow’s milk. “Special Milk Program” supplied over 41 million half pints of milk to children nationwide despite the fact that many doctors are talking about dairy harm to a human body. Milk is packed with growth hormones for a baby calf to grow to a 1600 lb adult in just a year – a growth more rapid than any human being. When the growth hormone acts on tissues, it releases an Insulin-like Growth Factor.  A 2009 study proved the link between the Insulin-like Growth Factor-1as well as few other hormones ingested with cows milk with acne, prostate and breast cancer.

Also interesting to note that even though most schools now ban sodas and other sugary beverages, chocolate milk still gets a pass. A single serving of chocolate milk contains between four and six teaspoons of sugar.

Policy Options:

1. Changes in distribution of funding

  • The United States Department of Agriculture purchases hundreds of millions of dollars worth of agricultural products and gives them to schools for free. This is very helpful, especially given the limited funding. However, in 2015, 64% of the program’s spending went to meat, dairy, and egg products. It is obvious that producing those products requires a lot more water, land, electricity and human workforce and, therefore, money  than it does to produce any plant-based foods. Redistributing those finances to purchase more vegetables and legumes will not only result in making a higher quantity of food available to the children but will also solve the nutrition density problem.
    • Advantages:  A much needed major school nutrition program reform
    • Disadvantages: In order to get implemented, may require a revision of the Nutritional Guidelines for Americans which needs recourses and a lot of lobbying. In addition, reallocating resources may dismantle many of existing agreements so entities profiting from current situation may vote against it.

2. Substituting cows milk to plant based milk for school milk program

  • In comparison to whole fat cow milk, oat milk has almost as many calories; nut milks are lower in sugar; soybean, pea and flaxseed have the same or higher amount of protein (9 g, 8g, and 8 g. vs. 8 g per cup), coconut has much lower sodium and the last, but not the least – almond, pea, and flaxseed milk have more Calcium than cow milk (560, 560, 450 mg vs. 425 mg per cup). It is also important to mention that animal milk naturally contains iron that hinders absorption of Calcium when ingested together. For optimal absorption, Iron needs to be consumed separately with Vitamin C.
  • Advantages: Children will receive all the health benefits of plant based milk, such as higher water content for better hydration, a superior form of hormone-free nutrients, and decreased risk of breast and cervical cancer
  • Disadvantages: Dairy is a surplus product from the meat production so it’s liquidated in the schools at a very low prices that would be hard to match by nutmilk producers. However, not impossible. 

3. Eliminating processed food vendors on site at schools

  • Just like smoking is banned in public places, for the similar reasons selling of the processed foods in schools should be banned. Children are very susceptible to marketing and also the convenience of getting a bag of potato chips from a vending machine is very attractive. Vending machines at schools should contain mostly healthy snacks like granola bars, nuts and seeds, oatmeal, dehydrated fruits, etc. Chocolate milks should be banned along with sodas
  • Advantages: Children will be less exposed to processed foods  and hopefully learn that healthy food can also taste good which can help in future develop healthier eating habits.
  • Disadvantages: Processed food is popular for a reason: it’s cheap in production and it can stay on the shelves forever. Also companies contracted with the schools to supply food may have certain agreements with the processed food companies that they might not want to break.

Policy recommendation: Given the staggering statistics on the prevalence of childhood obesity as well as the incidence rates of diabetes among children and adolescents, a need for a school nutrition reform is obvious. Changes in distribution of funding is the option with the highest impact. That high impact is it’s advantage and a disadvantage at the same time. If performed, it will transform how children eat at school and lead to a more optimal use of resources. However, it may require a lot of effort/money which, some may argue, could be unwarranted. Most likely parties arguing that would be the ones that profit from the current situation.  On the other hand, we have been needing a reform in Dietary Guidelines and in the School Lunch Program for quite a while now and 2020 might just be the year for it. Arguing for resource allocation in order to get the redistribution of funding enacted, it is important to note that  this change could prevent increased spending on the management of the comorbidities associated with childhood obesity and diabetes as well as the treatment of potential unknown complications from having disease at such a young age in future.

Sources:

https://usatoday30.usatoday.com/news/education/2009-12-08-school-lunch-standards_N.htm

https://www.cdc.gov/obesity/data/childhood.html

https://www.nejm.org/doi/full/10.1056/NEJMoa1610187

https://www.frac.org/wp-content/uploads/cnnslp.pdf

Danby F. W. (2009). Acne, dairy and cancer: The 5alpha-P link. Dermato-endocrinology1(1), 12–16. doi:10.4161/derm.1.1.7124

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