Monday, November 21, 2011

Pizza. A Vegetable?

I have the luxury of sending my children to school with a home-packed lunch whose nutritional value I have chosen. The mother of one of my patients in clinic does not. She, like many of our neighbors, relies on our school lunch program to provide meals to her 6-year-old daughter. This mother is grateful for the school lunch program. She is struggling to get her family back on its feet after losing almost everything to a natural disaster while concurrently serving as the primary caretaker of her elderly parents, who have had amputations resulting from complications of their diabetes. The meals the school offers are a much-needed resource. Unfortunately, last week these school meals suffered a setback that will not make this needed resource a healthier choice for her daughter, who at 6 years of age weighs more than me. I have worked for months to improve the health and behavioral habits of this child, and I am saddened to know that this needed meal resource will not be improved in nutritional content.

Pizza will likely continue to replace green beans as a vegetable in school lunch programs. The U.S. House of Representative approved a huge spending bill on Monday, Nov., 2011, that blocked rules proposed by the Agriculture Department that would have improved the nutritional value of the nation’s school lunches. The proposed rules released last January were the first in 15 years that would have improved the health of and nutrition for our children for a mere increase of 14 cents per school lunch. They would have reduced the amount of potatoes served, changed the ways schools receive credit for serving vegetables by continuing to count tomato paste on a slice of pizza only if more than a quarter-cup was used, and halved the amount of sodium in school meals over the next 10 years. The blockage of these rules dramatically weakens the nutrition standards for federal school-lunch programs. This is a very disappointing step in the wrong direction. With childhood obesity increasing across the United States, I rely on community strategies to support healthy living behaviors that I encourage within the walls of my clinic. It is essential to make school lunches healthier if children like the 6-year-old in my clinic are to make nutritional choices to improve their weight, and if others are to prevent obesity. In Texas, more than 20 percent of children are obese, and an overweight adolescent has an 80-percent chance of becoming overweight or obese as an adult. Texas’ obesity epidemic has stunning implications for the state’s health care system. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 41.5 percent more than treating normal-weight patients. It is only through the synergy of individual interventions along with community, state, and federal obesity prevention and intervention strategies that the battle against the disease of obesity will be won. The health of our children and the health of our nation cannot afford any less.

Kimberly Avila Edwards MD, FAAP 
Medical Director, Healthy Living Happy Living/Vida Sana Vida Feliz 
Texas Center for the Prevention and Treatment of Childhood Obesity 
Dell Children’s Medical Center of Central Texas

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