Sunday, October 23, 2011

Senate Posts New School Lunch Score: Potatoes 1, USDA 0

Spuds win out over kids' health

By Ed Bruske

aka The Slow Cook

In an unprecedented act of meddling in school lunch rule making, the U.S. Senate last week approved by unanimous consent a measure that forbids the U.S. Department of Agriculture from limiting the amount of potatoes in the national school meals program.

Mainstream media got it wrong: This was not a defeat for the Obama administration or for first lady Michelle Obama. Rather, it was a clear case of congressional double-speak, overturning a mandate Congress itself gave the USDA seven years ago to conform school meals with the Dietary Guidelines for Americans. The Senate action reverses the work of food science experts at the Institute of Medicine, who had spent years at the USDA's behest drafting the new guidelines Congress had ordered.

The problem with potatoes is that kids like them too much and schools serve them all the time in order to comply with the vegetable requirement in the school lunch program. The 2005 Dietary Guidelines for Americans, however, recommended eating a variety of vegetables daily and throughout the week.

Here's what those guidelines say:

Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 2½ cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level.

Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.

In order to align with those guidelines, the new school meal rules drafted by the Institute of Medicine, and embraced by the USDA, proposed limiting potatoes and other starchy vegetables such as corn, peas and lima beans to no more than 1 cup per week, and increasing the portions of dark green and orange vegetables and legumes.

That touched off a storm of protest from the potato industry, as well as numerous congressmen, who wrote the USDA demanding that the potato restriction be removed in the final rule. Last week's drubbing of the USDA process came in the form of an amendment to the 2012 agriculture spending measure jointly proposed by two senators from potato growing states, Susan Collins, Republican of Maine, and Mark Udall, Democrat of Colorado.

Collins and others argued the nutrition benefits of potatoes, suggesting schools should simply remove fatty french fries. Proponents of the new rule repeated the call for more vegetable variety in school meals. Perhaps they would have gotten further if they'd pointed out that starchy spuds are not an appropriate food to be feeding children in the middle of an obesity epidemic. A recent Harvard study, which looked at the eating habits of more than 120,000 American men and women over a 20-year period, found that potatoes more than any other food were associated with excess weight gain, regardless of whether they are fried, boiled or baked.

In fact, a growing body of scientific evidence suggests that obesity is not caused solely by a failure to burn off all the calories consumed, but by the metabolic effects of eating too many carbohydrates, especially highly glycemic carbs such as potatoes, refined grains and sugar.

The Senate action represents a naked display of agricultural interests and political emotion trumping the science around kids health. So I thought readers might like to see exactly what was motivating members of the Institute of Medicine committee when they wrote their 380-page report, first released in October 2009, proposing the school meal nutrition guidelines the Senate has not tossed overboard.

Here's what the committee said:

The overall goal was the development of a set of well-conceived and practical recommendations for nutrients and Meal Requirements that reflect current nutrition science, increase the meals’ contents of key food groups, improve the ability of the school meal programs to meet the nutritional needs of children, foster healthy eating habits, and safeguard children’s health.

In recognition of the need to update and revise the Nutrition Standards and Meal Requirements for the school meal programs, Congress incorporated requirements in the 2004 Child Nutrition and WIC6 Reauthorization Act (P.L. 108-265). In particular, the act requires USDA to issue guidance and regulations to promote the consistency of the standards for school meal programs with the standards provided in the most recent Dietary Guidelines for Americans...

Among the changes needed to improve consistency with the 2005 edition of Dietary Guidelines for Americans are the following:

  • Increasing the emphasis on food groups to encourage a healthier food consumption pattern, especially by offering variety and a larger amount of fruits and vegetables, and by offering whole grains as a substitute for some refined grains, and
  • Limiting the intake of saturated fat, trans fat, cholesterol, added sugars, and salt by offering foods such as fat-free (skim) milk or low-fat milk, fewer sweetened foods, and foods with little added salt.

Charge to the Committee

  • Specify a planning model for school meals (including targets for intake) as it may relate to nutrients and other dietary components for breakfast and lunch.
  • Recommend revisions to the Nutrition Standards and, in consideration of the appropriate age-grade groups for schoolchildren, provide the calculations that quantify the amounts of nutrients and other dietary components specified in the Nutrition Standards.
  • Recommend the Meal Requirements necessary to implement the Nutrition Standards on the basis of the two existing types of menu planning approaches (i.e., the food-based menu planning [FBMP] approach and the nutrient-based menu planning [NBMP] approach). The Meal Requirements are to include
    • standards for a food-based reimbursable meal by identifying
      • the food components for as offered and as served meals and
      • the amounts of food items per reimbursable meal by age-grade groups and
    • standards for a nutrient-based reimbursable meal by identifying
      • the menu items for as offered and as served and
      • the 5-day average amounts of nutrients and other dietary components per meal.
  • Illustrate the practical application of the revised Nutrition Standards and Meal Requirements by developing 4 weeks of menus that will meet the recommended standards for the age-grade groups.

Critical Issues for Consideration by the Committee on Nutrition Standards for National School Lunch and Breakfast Programs, as Submitted by the U.S. Department of Agriculture1

There are a number of important issues on which USDA particularly seeks guidance. In the descriptions below, we have raised a number of questions and concerns, as well as tentative policy concepts for IOM’s [Institute of Medicine] critical review. These are intended to clarify the scope of the committee’s charge, but not to constrain or pre-determine its recommendations. We also ask the committee to consider such operational factors as market conditions, impacts on student acceptability of meals, and the decision to participate in the program, in making recommendations in each of these areas.1

Calorie requirements:

Since the establishment of the school meal programs, the dietary concerns for children have shifted from preventing hunger and nutritional deficiencies to recognizing the increase of childhood overweight/obesity rates while enhancing cognitive performance and academic achievement. FNS [USDA's Food and Nutrition Services branch] requests that the committee provide recommendations for calorie levels in consideration of the best scientific information available (including the DRIs) that reflect the diversity of energy needs in today’s school children. FNS would like the IOM committee to provide minimum calorie requirements, and consider also recommending maximum calorie levels for reimbursable meals that take into consideration age-grade groupings.

Age-grade groups:

The NSLP [National School Lunch Program] nd SBP [School Breakfast Program] provide meals for children age two and older (generally, under 21). The meal programs group children according to age-grade and establish meal patterns with minimum portion sizes and servings to help menu planners design meals that are age-appropriate and meet the diverse nutritional needs of school children. Nutrient and calorie requirements are also determined for each age-grade groups. In light of the childhood obesity trend, FNS is concerned that school meals provide age-appropriate portion sizes and promote the development of healthy eating behaviors. We request that the committee recommend age-grade groups that are consistent for all menu planning approaches and reflect the stages of growth and development in children and adolescents.

School grade structures and meal service operations must be considered to ensure that age-grade group recommendations can be successfully implemented. Specifically, in the NSLP, some schools currently use a single age-grade group to plan meals for children and adolescents. The Department is concerned that for lunch meals intended to provide ⅓ of the RDAs without providing excessive calories, this practice may result in meals that fail to meet the nutritional needs of either group. While the same may be true for SBP, where the meals are intended to provide ¼ of the RDAs, FNS recognizes that there are different operational constraints. In the SBP, children typically participate as they arrive at school, rather than by grade level or other service schedule that would be common in lunch. The single age-grade group currently allowed for SBP menu planning is intended to provide flexibility to meet the needs of the SBP foodservice operation. Also of note, many schools have implemented alternative methods of delivering meals to promote student participation, such as Breakfast in the Classroom or Grab-and-Go Breakfasts. FNS requests that the committee consider the potential impacts that age-grade group requirements may have on the unique aspects of NSLP and SBP meal service, operations, and participation.

Nutrient standards:

FNS requests that in addition to the current required nutrients, the IOM committee consider the DGA [Dietary Guidelines for Americans] recommendations to minimize trans fats, as well as the intake recommendations for sodium, cholesterol, and fiber, which currently do not have quantitative standards in the school meal programs. Program operators are currently required to reduce sodium and cholesterol levels and to increase fibers levels. Monitoring these nutrients has been facilitated by the Nutrition Labeling and Education Act requirement that sodium, cholesterol, and fiber amounts be included on food labels and product specifications. Furthermore, trans fats information is now required to be included on the Nutrition Facts label and on product specifications, which would facilitate the ability of Program operators and administrators to monitor compliance with the trans fats recommendation.

Total fat:

The DGA recommendation for fat is to keep total fat intake between 30 to 35 percent of calories for children 2 to 3 years of age and between 25 to 35 percent of calories daily for children and adolescents 4 to 18 years of age. It should be noted that breakfast meals are often relatively low in fat (below 25 percent). The fat recommendation for each of the meals, in addition to the total daily fat range, should be considered in this process.

Available nutrient information:

Program operators and administrators rely in part on nutrition information provided by food labels and product specifications to plan and assess menus that meet the required nutrient levels. FNS is concerned that establishing requirements for nutrients that are not required to be listed on food labels and product specifications by the Nutrition Labeling and Education Act (NLEA, P.L. 101-535), such as the nutrients of concern for children including potassium, magnesium, and vitamin E, would be a burden to Program operators and administrators. FNS requests that nutrient standard recommendations take into consideration the availability of nutrient information on food labels and product specifications.

Sodium standard:

It is well-recognized that the current intake of sodium for most individuals in the U.S., including school-age children, greatly exceeds the DGA recommendation to consume less than 2300 milligrams (mg) of sodium per day. FNS has encouraged schools to reduce sodium in the NSLP and SBP since the implementation of the School Meals Initiative (SMI) in 1995; however, the School Nutrition Dietary Assessment Studies (SNDA I–III) consistently indicate that the efforts since 1995 have not resulted in any significant reduction of sodium levels in school meals, on average.

FNS is concerned that the challenge of reducing sodium levels in school meals extends beyond the efforts of Program operators and administrators alone. At present, sodium is a common addition to processed foods and convenience items which are commonly used in school meal programs to save time and reduce labor costs. Additionally, the availability of high so-dium foods at home, at restaurants, and at other locations in and outside of the school meals programs has resulted in a taste preference for salty foods which impacts student acceptability of school meals and Program participation. Furthermore, it takes time to change children’s taste preferences and for industry to respond to a need for low-sodium products in schools and the general market.

The USDA requests that the committee consider student acceptability, Program participation, and market conditions when making recommendations for sodium levels in school meals. Additionally, the Department requests that the committee consider a recommendation that would allow for a progressive or gradual reduction of sodium levels in school meals, such as interim targets, to ultimately meet a standard based on the DGA recommendation over a realistic period of time without adversely affecting program participation.

Vitamin A standard:

Current regulations require that school meals meet minimum levels of vitamin A expressed in Retinol Equivalents (RE), as specified in the 1989 RDAs. The nutrition facts panel on food products provides vitamin A levels in International Units (IU). The most recent DRI standards for vitamin A are quantified in Retinol Activity Equivalents (RAE). FNS is concerned that there is no direct conversion from the DRI recommendations in RAE to IU. FNS requests that the committee recommend a vitamin A standard that addresses the fact that Program operators and administrators rely both on values in nutrient analysis software (which may be in RAE, RE and/or IU) and on food labels and product specifications that quantify vitamin A in IU (i.e., percent of Daily Value in International Units). FNS recognizes that a conversion from levels expressed in RAE to IU may need to be based on representation of a mixed diet for school-aged children.

Menu planning approaches:

FNS would like the committee to examine the adequacy of the current menu planning approaches in meeting the applicable DRIs and DGAs. We are concerned that the structure of the current menu planning approaches, such as the Traditional FBMP and NSMP, may no longer be adequate to provide school meals that reflect the 2005 DGAs. Furthermore, FNS would like recommendations for a single food-based menu planning and a single nutrient standard menu planning approach. FNS requests that the IOM recommendations result in age-appropriate meals and reflect the applicable DRIs and 2005 DGAs under any menu planning approach.

Fruit, vegetables, whole grains and low-fat/fat-free milk products:

The Child Nutrition and WIC Reauthorization Act of 2004 amended the NSLA to require increased consumption of foods that are specifically recommended in the most recent DGAs. FNS is requesting recommendations to increase the availability of the food groups encouraged by the 2005 DGAs. FNS wishes to apply requirements for these food groups to ensure that all students in the NSLP and SBP have access to adequate amounts of these recommended foods, regardless of the menu planning approach used by their school foodservice authority.

Current NSLP regulations require that minimum servings of fruits and/or vegetables, fluid milk, and whole grain or enriched sources of grains/breads be offered daily in the food-based menu planning approaches. In the nutrient standard menu planning approaches, fluid milk is the only required food item to be offered and minimum serving requirements are not established. Under all menu planning approaches, whole grains are encouraged but not required. Additionally, all schools must provide a variety of fluid milk types (a minimum of two); regulations do not place restrictions on offering any milk-fat or flavored varieties.

In the SBP, meal patterns and menu structures have been designed to provide schools with flexibility to provide meals that reflect a typical breakfast meal and avoid unnecessary burden on school foodservice operations. FNS requests that the committee consider such differences between NSLP and SBP meal service operations when making recommendations to increase the food groups encouraged by the 2005 DGAs in the FBMP breakfast meal pattern and the NSMP menu structure.

Special considerations for whole grains:

  • In order to incorporate whole grains into the menus, schools must be able to accurately identify a creditable whole-grain product. An issue for FNS is helping schools easily identify whole grain products that provide a significant level of whole grains. At this time, the FDA has not published a definition of a whole-grain product, or a whole-grain serving. USDA wishes to establish a consistent definition for all the FNS Special Nutrition Programs (including NSLP, SBP, Child and Adult Care Food Program, the Summer Food Service Program (SFSP), WIC, and the FNS commodity programs).

Special considerations for fluid milk:

  • The NSLA and program regulations require that lunches include fluid milk and allow fluid milk in a variety of fat contents and flavors. Fluid milk may not be substituted by another beverage or dairy product, except when a disability precludes milk consumption.2 Under the FBMP approaches, a minimum of eight fluid ounces is required for school-age children and a minimum of six fluid ounces is required for preschoolers. No minimum quantity is required under the NSMP approaches. Since calcium is a nutrient of concern for children and milk is a primary food source of nutrients for children, FNS is seeking recommendations to implement the recommendations of the DGAs and DRIs. When considering this, the IOM expert committee should also address concerns that offering different quantity for the various age-grade groups in the NSLP and SBP may be operationally difficult to implement at the local school level due to procurement logistics and economies of scale.

Meat/Meat Alternate:

The current meat/meat alternate requirements in the NSLP meal patterns exceed the recommended quantities in the USDA Food Guide, the food pattern that illustrates the recommendations of the DGAs. The School Nutrition Dietary Assessment (SNDA) studies show that current meal patterns require more than adequate amounts of meat/meat alternate to meet the nutritional (protein and iron) needs of children and adolescents. There may be adjustments to existing meat/meat alternate requirements that could help schools limit food costs while still meeting the nutritional needs of participants. Schools could meet the meat/meat alternate requirement over the course of the week as long as a minimum serving of meat/meat alternate is offered daily. Consistent with the DGAs, schools should offer low-fat, lean meat/meal alternates to help children limit the intakes of saturated fat, total fat, and cholesterol. In addition, there is public interest in incorporating nutrient-dense meat alternatives such as soy-based products in the NSLP.

Offer versus Serve:

The IOM committee may need to be aware of Offer versus Serve, a statutory requirement intended to reduce plate waste in the lunch program. The NSLA requires that high school students be allowed to decline foods they do not intend to eat. Offer versus Serve may be implemented at lower grades at the option of the local school district. Program regulations require that students select at least three of the five food items offered in a food-based menu. For nutrient-based menus, the regulations require that students select the entrée. If three items are offered, students may decline one; if four or more items are offered, students may decline two.

Attainable recommendations:

The majority of schools prepare meals on-site with a small staff and restricted budget. Food purchasing, planning, preparation and service are often carried out by employees with no formal food service or management training. Changes to the meal patterns and nutrition standards must be feasible for school foodservice operators, and should not jeopardize student and school participation in the meal programs. To ensure that the combined set of recommendations are attainable, the Department requests IOM to include in the report separately for NSLP and SBP a set of four-week cycle menus for each of the recommended age groups that meet all recommendations, are relatively cost neutral and would not likely have an adverse effect on program participation.

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