Schools and Junk Food: Obesity, Politics and Money

By Vickie Mitchell

A plastic bag containing almost five pounds of sugar has become a weighty symbol of a lengthy and somewhat bitter battle to get sugary soft drinks and junk foods out of vending machines in Kentucky's public schools.

The bag equals the amount of sugar consumed by a person who drinks one 20-ounce non-diet soft drink a day for a month.

Carolyn Dennis, a registered dietician and the legislative co-chair for the Action for Healthy Kids Task Force, has carried the bag around the state Capitol to visually demonstrate the health hazards posed by sodas as she has tried to convince state lawmakers that legislation is needed to make schools put healthier drinks and snacks in their vending machines.

The vending legislation has been proposed - and defeated - in the last three legislative sessions.

But Dennis is undaunted. Late last fall, as the 2005 legislative session approached, she was again lining up support for the effort. She's convinced that a statewide mandate is the only way to ensure that all of Kentucky's public schools take action on junk food in schools, which she and others believe is leading to a growing number of fat, unhealthy Kentuckians.

"The obesity epidemic is happening so quickly that we don't have time to wait for little steps," she said. "We need policy changes. We, as adults, have to establish these standards."

Nationally, Kentucky ranks fifth in the percentage of obese adults and third in percentage of overweight high school students, according to the Trust for America's Health.

Bills proposed in the 2004 legislative session would have prohibited elementary schools from selling sodas, required that at least 75 percent of beverages sold in middle and high schools be healthy beverages, such as water and 100 percent fruit juices, and prohibited the sale during the school day of snacks with more than 40 percent added sugar by weight and more than six grams of fat.
  
Legislation also would have reinforced state regulations that prohibit vending machines from operating in competition with school cafeterias.
 
For the 2005 session, Representative Thomas Burch, D-Louisville, said he planned to file bills similar to those he and Representative Tim Feeley, R-Crestwood, have co-sponsored in the past. Senate Majority Leader Dan Kelly, R-Springfield, said that the Republican caucus in that chamber had expressed some interest in writing a bill to address school nutrition.
  
Opponents to vending legislation have ranged from lawmakers who said the bills were too narrowly focused and did not encourage local input, to the soft drink industry, which argues that the lack of physical activity by children - not its products - is the problem.
  
Money is also an issue - more specifically, money that the vending machines make for schools. Since vending machines arrived in school hallways more than 20 years ago, they have supplied schools with discretionary funds that are used for items, such as band uniforms, field trips or academic achievement awards, that are not financed by schools' regular budgets. Many principals are concerned about those funds dwindling if less-popular, healthier items are offered for sale in the vending machines.
  
The average high school made almost $10,000 from vending during the 2000-01 school year, according to a survey conducted in early 2002 by the University of Kentucky Cooperative Extension Service, the Lexington-Fayette County Health Department and the Kentucky Department for Public Health.
  
Somerset Independent School Superintendent Wilson Sears encountered concerns about that issue when he spoke about his district's new vending policy at a series of forums on obesity last fall. Somerset's new policy eliminated soft drinks and set nutritional guidelines for snacks.
  
"One of the big questions was 'What has this done to your vending funds?' and I said, 'It will dramatically reduce them,'" Sears said. "Will it rebound? I think it will. Will we ever sell the number of apple juices that we sold Pepsis? I doubt it."
 
Kentucky is not the only state grappling with the issue of school vending machines. Representative Feeley told legislators during the 2004 session that 20 other states had passed drink-vending laws similar to his and Burch's proposal.
  
In addition, some school districts in Kentucky and around the country are taking action, as are officials in other countries. Chicago Public Schools will ban all carbonated beverages in 2005. School boards in Los Angeles and New York have voted to ban soft drinks in schools.
  
In Canada, soft-drink companies decided to stop selling sodas in elementary and middle schools. France has banned soft drinks and snacks in school vending machines.
  
The proliferation of policies makes Ray Gillespie, a consultant for the Kentucky Soft Drink Association, wonder if the attack on vending has become the fashionable response to childhood obesity problems. The association has lobbied against vending legislation, arguing that choice of food and beverage is a matter of personal responsibility and that a lack of physical activity is the culprit.
  
"We've long worked against the people who jump on what I call a fad solution,"he said. "They think if we ban something that will take care of it."
  
Vending bill proponents maintain that soft drink companies want to continue selling sodas to build brand loyalty among youngsters. In addition, the proponents contend that the companies' profit margins on soft drinks are higher than on more healthy waters and fruit juices.
  
From Senator Kelly's perspective, the proposed legislation has been "too superficial."
  
"The legislation doesn't really get at the core of the problem, which is bad nutrition throughout the schools," he said. Two years ago, he and some other legislators suggested an alternative to vending legislation.
  
Their proposal would have required school districts to have a licensed nutritionist evaluate foods in schools and make a report to the public and the school board. The school board would then use the report to develop a plan that would be released in a public forum to encourage parental input and involvement.
  
Regardless of how future legislative proposals fare, other schools are feeling other pressures in regard to their role in children's health.
  
By the 2006-007 school year, all schools that participate in the federal school lunch program - including all of Kentucky's public schools - will be required to develop health and wellness plans aimed at improving physical activity and the nutritional value of foods consumed in schools.
  
"This puts everybody on notice that Congress is concerned, and that they are expecting school districts to play a part in addressing the issue," said Paul McElwain, director of the division of school and community nutrition for the state Department of Education.

In addition, the state Department of Education's 2005 legislative package includes a measure that would require schools to develop a health and wellness plan that would be more comprehensive than the one Congress is requiring.
  
Although legislative efforts have failed so far, awareness of junk foods in schools has been raised, Dennis said. "Prior to the task force getting vocal about the issue, it wasn't on people's radar." 
  
However, Dennis believes that many schools will never make the change to healthier vending on their own and that the force of state law is necessary. "If I live to be 80, I don't believe all 176 school districts will voluntarily do the right thing," she said.
Sears, whose schools made the change at the local level, agrees that a state mandate is needed.
 
"I believe it is absolutely necessary to have some kind of vending legislation come out of Frankfort," he said. "Some schools that possibly need the vending revenue just aren't going to support it."
  
Others, he believes, will argue that it is not the schools' job to tell children what to eat.  But ultimately, he said, schools will suffer financially if health issues aren't addressed as tax dollars are directed away from schools and other areas to pay for taking care of a growing number of Kentuckians who suffer from diabetes, heart disease and other ills associated with obesity.
  
All involved with the issue agree that the causes of childhood obesity go beyond school vending machines. Cafeteria a la carte lines sometimes offer unhealthy items to compete with those sold in vending machines. Physical activity has significantly decreased on and off school grounds. And what children eat and drink at home is also a factor.
  
"I know this (vending) is not what is making kids obese," said Representative Charlie Miller, D-Louisville, a former high school principal who has opposed vending legislation in the past. "Look at all the calories in fast food. What is a soft drink or candy bar compared to that?"
   
"This (vending legislation) is only a beginning," Butch said. "A lot of this has to begin in the homes, too." 
  
McElwain agrees. "We could serve them bushes and trees all day long, but if after school they go home and spend four hours in front of the TV with a two-liter bottle of Pepsi and four bags of Doritos, it doesn't matter what we served them at school. The schools can't do this all by themselves." 
  
But at the same time, schools shouldn't contribute to the problem, Burch said. "Schools don't have to be an aider and an abettor."
  
Janey Thornton, director of child nutrition for Hardin County Schools and a vice president of the American School Nutrition Association, believes education is an essential part of the process. Schools in her district have run several healthy vending pilot programs.
  
"We have seen such a difference in how kids eat when we offer them a lot of healthy choices," she said. "We need to educate them on why to take those healthy choices.
  
"The whole thing comes back to education. It took us many years to get in the mess we are in right now, and it is going to take us a long time to get out of it, and it is not going to be just the schools."

The importance of community consensus

Does building community consensus make it easier to swallow changes in school vending? The experiences of two Kentucky school districts, Somerset Independent and Christian County, seem to indicate so.
  
Each implemented new policies last fall that put healthier foods and drinks in their school vending machines. Health and wellness committees composed of local citizens made the recommendations.
  
Somerset Independent and Christian County are among more than a dozen of Kentucky's 176 school districts, including three of the largest - Jefferson, Fayette and Daviess counties - that have put healthier foods and drinks in their vending machines in the past several years.
  
The Kentucky Soft Drink Association, which has fought vending legislation in the past three legislative sessions, does not oppose changes made at the local level, according to consultant Ray Gillespie. "That is perfectly appropriate, schools making those local decisions," he said.
  
In Somerset, citizens representing education, health care, recreation and business were recruited by Superintendent Wilson Sears, who believed a diverse group would help ensure community acceptance of the idea.
  
In Christian County, parents, a physician, a school nurse and a food service director studied the vending issue.
  
Working at the local level had its advantages. The Christian County committee encountered none of the opposition that statewide legislation has received from soft drink and grocers' lobbyists. Local suppliers willingly came up with healthy snack alternatives, according to Dr. Karen Dougherty, a school board member and pediatrician at the local health department who served on the committee.
 
Companies quickly got creative when told, "If you are going to sell it in our machines it must meet this criteria," she said. 
  
The conversations with districts with similar policies gave the committee a network of contacts for local principals who wanted more information on the impact of such changes.
  
The Somerset committee's recommendations went beyond the state-level proposals. All soft drinks have been removed from vending machines and replaced with water and fruit juices. Somerset's policy also prohibits teachers from using unhealthy foods as rewards and parents from bringing unhealthy treats to the classroom. In addition the vending policy applies to all machines in district facilities - from the district office to the bus garage to teachers' lounges. 
  
"We said if we as a school system and as a school board and health and wellness committee are going to talk the talk we need to walk the walk," Sears said. "The kids don't have a lock on obesity."

To gauge the changes' long-term impact on health, students' body mass index was calculated, and dental screenings were conducted on elementary students.
  
The committees' work will continue in both districts. In Somerset, finding ways to incorporate more physical activity during the school day is the committee's next assignment.
 
Having healthier food throughout schools is the goal in Christian County. "We decided that vending had to be the first thing," Dougherty said. "But vending machines are just a piece of trying to build a healthier school environment."
  
Locally orchestrated, comprehensive approaches like those in Somerset and Christian County are the direction that schools should take, said Paul McElwain, director of the division of school and community nutrition for the state Department of Education.
  
He suggests that school councils are a logical group to tackle the task.

"It is not going to be enough to address what is in vending machines," he said. "Part of the problem with the proposed legislation is that it didn't provide any kind of long-term solution, and it didn't involve the community at all. There needs to be buy-in at the local level."