Since 2005, the Institute of Medicine (IOM), a Washington DC-based organization of physicians and scientists who write reports on health topics at the behest of federal agencies, has issued four studies on the causes and consequences of childhood obesity. The latest, Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth, appeared in March but vanished immediately with barely a trace. This is a pity. In some respects, the report is sensational. It clearly implies that junk foods should not be sold in schools and that all foods sold in schools --no exceptions-- should be foods that promote kids' health.
This IOM committee was particularly tough on soft drinks. Beverages offered in schools, it said, should contain hardly any sugars, no added caffeine, and no artificial sweeteners (except for high school students after school). No sports drinks should be allowed except to student athletes engaged in more than one hour of vigorous activity per say. And my favorite: "plain, potable water [should be] available throughout the school day at no cost to students."
That hardly anyone recognized these recommendations as breaking new ground must surely be due to their complexity and, alas, to their internal contradictions. This was, after all, a committee report. On the one hand, it called for getting junk foods out of schools. On the other, it established criteria that continue to allow plenty of junk foods to be sold in schools in competition with USDA school meals programs.
School meals may be awful, but they sometimes contain real food and do have to meet nutritional standards. In contrast, junk foods --the pejorative for what we nutritionists are supposed to call "foods of minimal nutritional value"-- are highly processed and loaded with calories, sugars, salt, and additives to make them sort of look, feel, and taste like real foods.
Pretty much everyone in my generation remembers school food as ghastly, perhaps explaining why we allowed junk food to infiltrate and take over school meal programs with hardly a word of protest. Most schools today offer two categories of foods: (a) meals that meet federal nutrition standards, and (b) competing snack foods and drinks that don't have to.
The federal rules are about nutrients; they say nothing about freshness, how the foods are produced, or how they taste. Hence, ghastly (although there are important and increasing exceptions). Schools raise money by selling junk foods during breaks, after school, and at sports events. If kids eat junk food, they don't eat school meals. Hence: competitive.
Complaints about competitive foods have been recorded for decades but Congress has consistently denied pleas to ban junk foods from schools. Instead, under pressure from food companies eager to sell their products to children and, unfortunately, from principals and school boards eager to raise funds from such sales, Congress just specifies where and when it is OK to sell junk foods in schools.
Concerns about childhood obesity have forced reluctant food companies to alter the nutritional content of their products to make them look healthier. They take out the trans fats, reduce the sugars, and add artificial sweeteners and fiber. No, they are not claiming that the reformulated products are health foods; what they do say is that the new products are better options. Whether a better junk food will really make people healthier is a hypothesis that has yet to be tested, but it does do one thing. It makes the product a lot easier to sell as good for your children. As examples, consider whole grain Cocoa Puffs, trans fat-free snack chips, and artificially sweetened breakfast cereals.
Despite the evident flaws in this approach, the IOM committee adopted it to some extent. It divided junk foods into two Tiers based on long lists of nutritional standards. Tier 1 foods are real foods (fruits, vegetables, grains, etc) as well as snack foods and beverages that do not exceed certain limits on calories (200 per serving), fat (35 percent of calories), saturated fat (less than 10 percent of calories), trans fat (basically none), sugars (35 percent of calories), sodium (200 mg or less), and caffeine (also basically none). Tier 2 foods, which are allowed for high school students after school, are pretty much the same except that those kids get to drink artificially sweetened sodas.
The most eyebrow-raising standard is that for sugars. Doesn't 35 percent of calories seem like a lot? Well, soft drinks contain 100 percent of calories from sugars and all are excluded by this criterion. But then there are the exceptions. Fruits and fruit juices qualify regardless of their sugar content (good, because these foods contain plenty of useful nutrients). But the IOM gives dairy foods a big break. Low-fat milks can contain up to 22 grams of sugars (88 calories worth) in 8 ounces, and low-fat yogurt can contain up to 30 grams (120 calories) in 8 ounces. These greatly exceed the 35 percent cutpoint.
The rationale for the dairy product exception is that these foods are good sources of calcium. The IOM committee wistfully says that it is "mindful of the positive efforts of some states and school districts, sometimes working together with the dairy industry, to successfully develop products lower in added sugars." One can hope. Attribute this exception to brilliant, unrelenting lobbying by dairy trade groups to convince nutritionists that dairy foods are the best, if not only, source of calcium (an issue I discuss in Food Politics and in What to Eat, and Nicholas Zamiska neatly discussed in The Wall Street Journal).
But high marks to the IOM committee for its water recommendation. The lack of free, readily available, potable water in public schools is nothing less than a national scandal. School water fountains are routinely broken, not maintained, dirty, and widely perceived as hazardous. Instead, kids have to buy bottled water. This is a solvable problem and schools ought to be doing something about it, and right away.
As for the "better-for-you" approach: These products may be better choices, but they are not necessarily good choices. Children would be much better off eating fruits, vegetables, whole grains, and healthfully raised meat and dairy foods, not foods that are highly processed. Schools that have gotten rid of the junk foods, replaced them with less processed foods, and instituted programs that teach kids where foods come from and how to cook are a joy to behold. You want your kids' schools to be like that? There are plenty of places that can offer help.