(FORTUNE Small Business) — Driven by curiosity and customer demand, Marc Geman, CEO of the Spicy Pickle restaurant chain, sent 30 of his top-selling dishes to a testing lab for nutritional analysis. It cost him about $2,500, but he learned everything about each dish, from calories to sodium content, which he then posted on the Spicy Pickle website.
“It was expensive to do, especially for a small business like us,” says Geman, whose Denver-based company of six stores and 30 franchises pulled in about $20 million last year. “But I understand that people want to know what they’re eating.”
Geman is one of a growing number of restaurateurs embracing nutritional disclosure - before the government demands it. To fight an obesity epidemic, dozens of cities and states are considering laws that mandate the posting of nutritional information on menu boards. Officials are targeting chains, because according to a study by market research firm NPD Group, that’s where Americans eat 64% of their restaurant meals.
Early adopters include New York City, where a judge recently enforced the hotly-contested law; San Francisco, whose laws take effect in the fall; and King County (Seattle), Wash., which will make changes Jan. 1.
On a national level, U.S. Senator Tom Harkin, D-Iowa, reintroduced legislation in March mandating that chains with at least 20 locations disclose calories, fat, and sodium on menus. While the various laws and proposals differ, most demand that chains with at least 15 restaurants display a calorie count for each dish (including the 2,900-calorie cheese fries at Outback Steakhouse) on or next to menu boards, and post more extensive information elsewhere in the restaurant. Sit-down chains must insert the information into individual menus.
Getting and posting nutritional information isn’t cheap, but it’s not prohibitively costly either. Beyond the testing fee, Geman estimates that it will cost him and his franchise owners about $5,000 a restaurant to redo the menu boards. But he and other smart owners of small restaurant chains are embracing disclosure as a marketing tool and as a way to discourage officials from outright bans on certain foods and ingredients. (New York City’s trans-fat prohibition takes effect in July; Maryland may mimic Chicago’s ban on the sale of foie gras.)
These owners also see disclosure as a way to get on the right side of customers. A survey by food services giant Aramark found that 83% of diners want restaurants to make nutritional information available.
“We’ve seen a jump in orders not only because of the laws but because more restaurants are getting requests from consumers for the nutritional composition,” says Erica Bohm, a vice president at Healthy Dining, based in San Diego, which charges $150 for a software-based nutritional analysis of a plate of food. (Lab studies cost $600 to $800.) Bohm estimates that in the past two years requests for software analysis have risen 50%.
Reflecting the view of most industry groups, Chuck Hunt, executive vice president of the New York State Restaurant Association’s New York City office, derides the disclosure laws as cumbersome micromanagement of small businesses. And, he adds, “14 years ago the FDA started requiring nutritional information on goods to be eaten in the home. Has that addressed obesity?”
Maybe not, but more consumers are demanding the ability to make informed choices in restaurants. And for both diners and business owners, laws requiring disclosure are far better than the alternative: nanny-state restrictions on what can be served.
For restaurant owners looking to the future, the smart move is to accept the inevitable and try to soften the laws’ harsh edges. The National Restaurant Association is advocating more flexibility in sign requirements, and Washington State’s restaurant association negotiated raising the minimum chain size from ten to 15 and allowing restaurants to post calories on signs near menu boards.
“Once we got the ordinance changed, I think people’s comfort level rose,” says Trent House, WRA’s director of government affairs.
The Original SoupMan - a 32-location chain based on the Seinfeld Soup Nazi character - is embracing disclosure as a way to differentiate itself in a saturated market.
“We’re for it,” says president Bob Bertrand, who has paid around $10,000 to have his 40 soups analyzed. “If people see that our nutritionals are better than another fast food, we think that can be good for us.”
Even Kings and Queens are facing their own food crisis.
Kings and Queens Counties, that is.
A continuing decline in the number of neighborhood supermarkets has made it harder for millions of New Yorkers to find fresh and affordable food within walking distance of their homes, according to a recent city study. The dearth of nearby supermarkets is most severe in minority and poor neighborhoods already beset by obesity, diabetes and heart disease.
According to the food workers union, only 550 decently sized supermarkets — each occupying at least 10,000 square feet — remain in the city.
In one corner of southeast Queens, four supermarkets have closed in the last two years. Over a similar period in East Harlem, six small supermarkets have closed, and two more are on the brink, local officials said. In some cases, the old storefronts have been converted to drug stores that stand to make money coming and going — first selling processed foods and sodas, then selling medicines for illnesses that could have been prevented by a better diet.
The supermarket closings — not confined to poor neighborhoods — result from rising rents and slim profit margins, among other causes. They have forced residents to take buses or cabs to the closest supermarkets in some areas. Those with cars can drive, but the price of gasoline is making some think twice about that option. In many places, residents said the lack of competition has led to rising prices in the remaining stores.
The residents of the Ingersoll Houses in Fort Greene, Brooklyn, have been without their local supermarket since last year, when it was razed along with a strip of stores and restaurants to make room for new housing and retail developments. What used to be a quick jaunt across the street for Della Dorsett is now a tricky trek, as she maneuvers her electric wheelchair several blocks uphill along Myrtle Avenue, returning home with plastic bags dangling from handles and nestled between her feet.
“I’m tired of going uphill,” she said. “But we have nothing around here now. From Myrtle to St. Edwards and down to Flatbush, not one store.”
The lack of easily available fresh food has prompted city and state officials to convene several task forces to address the public health implications.
The recent study conducted by the Department of City Planning estimated that as many as three million New Yorkers live in what are considered high-need neighborhoods — communities characterized by not enough supermarkets and too many health problems. Within those dense, urban areas, the study estimated that 750,000 people live more than five blocks from a grocery or supermarket.
“Many people in low-income neighborhoods are spending their food budget at discount stores or pharmacies where there is no fresh produce,” said Amanda Burden, the city’s planning director. “In our study, a significant percentage of them reported that in the day before our survey, they had not eaten fresh fruit or vegetables. Not one. That really is a health crisis in the city.”
The study, which was released last Friday, found that there is enough need in the city to support another 100 groceries or supermarkets. To spur supermarket growth, officials could consider using city-owned property or economic incentives, or relaxing requirements to make it easier to set up stores in areas zoned for manufacturing, Ms. Burden said.
“We have to determine why the stores are closing and what the barriers are,” Ms. Burden said. “Stimulating the investment of supermarket owners in these communities is essential to the future of the city.”
Jimmy Proscia, the co-manager of a Key Food in Flushing, says the business has gotten a lot harder in the 33 years since he started. Competitors, he said, cut costs by hiring nonunion workers. Big-box stores buy in bulk and further eat into his sales. Some days it looks like everybody is in the food business.
“You got gas stations now selling milk for $2.99,” he said. “Go to the drug store and they’re selling what we have. It’s ridiculous.”
In St. Albans, Queens, several empty supermarkets line the streets. Every day, Desiree Gaylord walks past a shuttered Associated store on Farmers Boulevard and on to her elderly mother’s house.
“Before I go to work, I call to see what she needs,” Ms. Gaylord said. “I’ll buy it somewhere else and bring it to her. I don’t know why they closed that store. It was an asset, especially for the elderly. Now I see them on the bus with the shopping carts.”
She walked down the street, past the corner house where Elizabeth Lopez moved in just last month. Ms. Lopez had been told there were plenty of places to shop in her new neighborhood. What she found were bodegas. By the time she gets home from her job driving a school bus, the closest supermarket is usually closed. So she drives to Brooklyn each week for her groceries.
“My husband hasn’t even seen this house yet because he’s been in Puerto Rico dealing with his relatives,” she said. “He is going to have a fit. He likes his stores close by.”
The residents who live in the high-rises and private homes that ring Bruckner Plaza in the Bronx can relate to that. Their local supermarket, a Key Food on White Plains Road and the Bruckner Expressway, is the only one south of the expressway, tucked into a corner of the outdoor shopping center that also features a Kmart and assorted smaller stores.
Executives at Pick Quick Foods, which owns the supermarket, say that Vornado Realty Trust, which bought the shopping plaza for $165 million last year, wants to double their rent to $50 a square foot. They fear the landlord wants to push them out.
Pick Quick used to own 15 Key Food stores, which are part of a buying cooperative. Now they are down to six. The smaller stores — those under 10,000 square feet — could not make enough of a profit to stay open. Other stores were priced out of their spaces by rent increases.
At stake at the Bronx store are more than 100 jobs, many of them filled by local residents, including teenagers and single mothers. Some of the employees more or less grew up in the business, starting as teenagers with part-time, unionized jobs. The pay and benefits have helped them support their families, and even prosper.
“What does this job mean to me?” said James Hutcherson, the store’s frozen foods manager. “I got a house and a daughter in college. That’s what I got out of this place.”
He is 46, and values his job so much that he takes three buses each day from his house in Queens. Both his father and his uncle worked for the company.
“I’m used to the people around here,” he said. “I’m used to the whole neighborhood.”
He excused himself to help a customer find several bags of ravioli that were on sale. Nearby, Efrain Rosa, 66, carefully read the list of ingredients on some Lean Cuisine meals. He is a diabetic, and he has to watch his diet. Like other older people in the neighborhood, he is worried that if Key Food closes, the shopping choices on his side of Bruckner Boulevard would be severely limited. Getting to the next closest supermarket — a Pathmark on the north side of the boulevard — would add more than a half-mile to the round-trip walk. Other options are not appealing.
“There is a grocery store across from me,” he acknowledged. “But they don’t carry the kind of groceries we want. Of course, their prices are higher too.”
Local 1500 of the United Food and Commercial Workers Union, which represents the store’s workers, have made this Key Food in the Bronx the poster child for a citywide campaign to preserve local supermarkets.
“We’re at a point where landlords do not feel any concern that they are taking supermarkets out of communities,” said Pat Purcell, the union’s director of special projects. “They just want to maximize their profit. I get that, up to a point. But food is different. It affects your health.”
Wendi Kopsick, a spokeswoman for Vornado, said she would not comment on the record about the company’s plans to renew Key Food’s lease. But Vornado’s Web site lists the Bronx parcel as available for “proposed retail.”
Whatever plans the company has for the site are bound to face opposition from the local community board, whose members expect to meet with Vornado executives this week. Enrique Vega, the chairman of Community Board 9 in the Bronx, said the board would not allow anything but a supermarket on the site.
“They are in deep trouble if they think they are going to put another type of store there,” Mr. Vega said. “They’ll need a variance or an agreement with the community board, and they are not going to get it. We want a supermarket.”
New research challenges the notion that you can be fat and fit, finding that being active can lower but not eliminate heart risks faced by heavy women. “It doesn’t take away the risk entirely. Weight still matters,” said Dr. Martha Gulati, a heart specialist at NorthwesternMemorialHospital.
Previous research has gone back and forth on whether exercise or weight has a greater influence on heart disease risks.
The new study involving nearly 39,000 women helps sort out the combined effects of physical activity and body mass on women’s chances of developing heart disease, said Gulati, who wasn’t involved in the research.
The study by Harvard-affiliated researchers appears in Monday’s Archives of Internal Medicine.
Participants were women aged 54 on average who filled out a questionnaire at the study’s start detailing their height, weight and amount of weekly physical activity in the past year, including walking, jogging, bicycling and swimming. They were then tracked for about 11 years. Overall 948 women developed heart disease.
Women were considered active if they followed government-recommended guidelines and got at least 30 minutes of moderate activity most days of the week, including brisk walking or jogging. Women who got less exercise than that were considered inactive.
Weight was evaluated by body mass index: A BMI between 25 and 29 is considered overweight, while obese is 30 and higher.
Compared with normal-weight active women, the risk for developing heart disease was 54 percent higher in overweight active women and 87 percent higher in obese active women. By contrast, it was 88 percent higher in overweight inactive women; and 2 1/2 times greater in obese inactive women.
About two in five U.S. women at age 50 will eventually develop heart attacks or other cardiovascular problems. Excess weight can raise those odds in many ways, including by increasing blood pressure and risks for diabetes, and by worsening cholesterol. Exercise counteracts all three.
“It is reassuring to see that physical activity really does make an impact,” said lead author Dr. Amy Weinstein of Boston’s BethIsraelDeaconessMedicalCenter. However, she added, “If you’re overweight or obese, you can’t really get back to that lower risk entirely with just physical activity alone.”
University of South Carolina obesity expert Steven Blair, a leading proponent of the “fit and fat” theory, said the study is limited by relying on women’s self-reporting their activity levels. That method is not as reliable as a more objective fitness evaluation including exercise treadmill tests, Blair said. These tests include heart-rate measures to see how the heart responds to and tolerates exercise.
In Blair’s research, overweight people deemed ‘fit’ by treadmill tests did not face increased risks of dying from heart disease.
Dr. Laura Concannon, who specializes in treating overweight patients at Chicago’s Advocate Illinois Masonic Medical Center, said the study’s message that exercise can help reduce health risks isn’t new, but it’s important.
“Anything that can motivate the public is useful because heart disease is becoming a bigger and bigger problem as levels of obesity increase,” Concannon said.
Historic Reversal, Found in 1,000 Counties, May Be Result of Smoking and Obesity
By David Brown
Washington Post Staff Writer
For the first time since the Spanish influenza of 1918, life expectancy is falling for a significant number of American women.
In nearly 1,000 counties that together are home to about 12 percent of the nation’s women, life expectancy is now shorter than it was in the early 1980s, according to a study published today.
The downward trend is evident in places in the Deep South, Appalachia, the lower Midwest and in one county in Maine. It is not limited to one race or ethnicity but it is more common in rural and low-income areas. The most dramatic change occurred in two areas in southwestern Virginia (Radford City and Pulaski County), where women’s life expectancy has decreased by more than five years since 1983.
The trend appears to be driven by increases in death from diabetes, lung cancer, emphysema and kidney failure. It reflects the long-term consequences of smoking, a habit that women took up in large numbers decades after men did, and the slowing of the historic decline in heart disease deaths.
It may also represent the leading edge of the obesity epidemic. If so, women’s life expectancy could decline broadly across the United States in coming years, ending a nearly unbroken rise that dates to the mid-1800s.
“I think this is a harbinger. This is not going to be isolated to this set of counties, is my guess,” said Christopher J.L. Murray, a physician and epidemiologist at the University of Washington who led the study. It is being published in PLoS Medicine, an open-access journal of the Public Library of Science.
Said Elizabeth G. Nabel, director of the National Heart, Lung and Blood Institute of the National Institutes of Health: “The data demonstrate a very alarming and deeply concerning increase in health disparities in the United States.”
The study found a smaller decline, in far fewer places, in the life expectancy of men in this country. In all, longevity is declining for about 4 percent of males.
The phenomenon appears to be not only new but distinctly American.
“If you look in Western Europe, Australia, Japan, New Zealand, we don’t see this,” Murray said.
About half of all deaths in the United States are attributable to a small number of “modifiable” behaviors and exposures, such as smoking, poor diet and lack of exercise. Although it is impossible to know exactly what is going on in the 1,000 counties, Murray thinks it “would be a reasonably obvious strategy” to target them for aggressive public health campaigns.
Life expectancy is not a direct measure of how long people live. Instead, it is a prediction of how long the average person would live if the death rates at the time of his or her birth lasted a lifetime.
For that reason, life expectancy can dip or rise abruptly. The death rate from the Spanish flu was so high, especially among the young, that life expectancy fell by about seven years in 1918. But it rebounded quickly when the epidemic was over.
In general, though, it takes huge forces to drive down life expectancy over longer periods. The AIDS epidemic has done so in some African countries. In the early 1990s, the social disruption following the collapse of the Soviet Union decreased life expectancy of Russian men by six years and of women by three years — an unprecedented decline in a modern industrialized nation.
In the study, Murray and collaborators at the Harvard School of Public Health examined mortality and cause-of-death data for the United States from 1961 through 1999. They divided the country into 2,068 units, including cities, counties or combinations of counties.
Across that four-decade period, average life expectancy nationwide increased from 66.9 years to 74.1 years for men, and from 73.5 years to 79.6 years for women.
From 1961 to 1983, life expectancy went up everywhere for both sexes. This was largely because the death rate from heart attacks, which had been rising for half a century, began to fall in the late 1960s. There were two reasons.
Huge numbers of people lowered their chances of having a heart attack by modifying “risk factors,” such as smoking, hypertension and high cholesterol. Improvements in medicine — coronary care units, use of aspirin and beta-blocker drugs, and various surgical procedures — greatly increased survival in patients with heart disease. About two-thirds of the longevity gained over the past four decades has come from the decrease in cardiovascular deaths.
These changes were so dramatic that even the poorest and least healthy groups benefited. In fact, counties with low life expectancy in 1961 had steeper rises over the next dozen years than counties that started out with high life expectancy. Overall, the drop in heart attack deaths more than offset rising mortality from cancer, emphysema and diabetes during this period.
By the early 1980s, however, the rapid gains were coming to an end. The low-hanging fruit on the tree of heart-attack prevention and treatment had been picked. Further strides tended to happen mostly in places where people were already healthy and long-lived.
As a consequence, the rise in longevity began to stagnate in places with the least-healthy people. In those counties, life expectancy increased by only one year (from 74.5 to 75.5) between 1983 and 1999, while in the healthiest places the life expectancy of women had reached 83.
It was during this interval that women’s life expectancy fell in nearly 1,000 counties. If one adds counties where it rose only insignificantly, then 19 percent of American women — nearly 1 in 5 — are now experiencing stagnating or falling life expectancy.
The trend was far less pronounced for men. That is because they entered the 1980s with higher death rates from heart attacks than women, and thus gained more from better prevention and better treatment. In the 1990s, however, AIDS and homicide began to take large tolls, depressing male life expectancy in some places.
Murray’s team, which also included Ari B. Friedman of Harvard and Sandeep C. Kulkarni of the University of California at San Francisco, used Internal Revenue Service data to check whether high levels of migration, or migration of people with particularly high or low incomes, might explain the discrepancy between the 1,000 counties and their neighbors. They found no evidence for it.
Unlike some European countries, the United States does not collect health information other than birth and death statistics at the local level. Instead, there are national, state and regional surveys of people’s health, behavior and access to medical care. Trends those studies have picked up shed light on what is happening in the 1,000 counties.
Obesity has risen markedly in the past two decades, with women more affected than men. About 33 percent of women are now obese, compared with 31 percent of men. Extreme obesity is twice as common in women (7 percent) as in men (3 percent).
Being overweight greatly increases the risk of developing Type 2, or “adult-onset,” diabetes. A national survey in 2002 found that 85 percent of diabetics were overweight or obese.
In recent years, the prevalence of high blood pressure has been increasing in women, as well — partly the result of weight gain. In 1990, 42 percent of women older than 60 had hypertension; by 2000 it was 51 percent. (In men, the trend is still dropping, as it has been for several decades.)
“This is a story about smoking, blood pressure and obesity,” said Majid Ezzati, of the Harvard Initiative for Global Health, a co-author of the paper.
By Beth Jinks
April 9 (Bloomberg) — Obesity costs U.S. businesses about $45 billion a year in medical expenses and lost work, according to a report today from The Conference Board.
Being severely overweight is associated with a 36 percent increase in spending for health-care services — more than smoking or problem drinking, the New York-based business research group found. Medication spending is 77 percent higher for obese patients, the report said.
More than 30 percent of American adults are obese, up from 15 percent in 1980, and treating the condition consumes 5 to 7 percent of the U.S. national health-care budget, the report said. Obesity makes people more susceptible to diabetes, heart problems and other serious conditions.
“Employees’ obesity-related health problems in the U.S. are costing companies billions of dollars each year in medical coverage and absenteeism,” Linda Barrington, a report co-author and labor economist at The Conference Board said in a statement. “Employers need to pay attention to their workers’ weights.”
Obesity is defined by body mass index, or BMI, a measurement that takes the patient’s weight in kilograms and divides by the square of the height in meters. A person with a BMI of at least 30 is considered obese, 25 to 29.9 overweight and 18.6 to 24.9 is seen as normal weight.
Offering employees incentives including cash, extra paid vacation days or insurance rebates to lose weight may be more effective and cheaper than health promotion programs, some researchers said in the report.
To contact the reporter on this story: Beth Jinks in New York at bjinks1@bloomberg.net
For Immediate Release
(New Orleans) - New Orleans-based World’s Healthiest Pizza (WHP) will begin posting calorie and other nutrient information directly on all in-store menu boards and take-out menus by May 20, 2008 - following important trends underway in other areas of America.
“Consumers are becoming increasingly interested in calculating daily caloric intake and in order to do that, it’s important that restaurants provide that information in highly visible areas,” says Jeff Leach, WHP Co-founder.
“We feel it’s our responsibility to our customers to provide full disclosure on the calories and other nutrients in our products and WHP wants to take a leadership role in New Orleans in getting out in front of what will certainly be requirement for any restaurant that wants to compete for increasingly nutritional savvy customers,” says WHP Co-founder Randy Crochet.
According to a new statewide poll commissioned by the Center for Science in the Public Interest and the American Heart Association in Washington, consumers are not very good at identifying calorie counts for typical restaurant meals.
In addition to providing caloric information for all specialty pizzas and popular combinations of toppings, WHP will provide the estimated fat and fiber content per serving. “With our low calorie / high fiber per slice product offering, WHP will continue to draw distinctions between what we see as the pizza of the future and what is currently being offered in market today. Continuing to pretend and ignore the role that pizza may be playing in our national epidemic of obesity and diabetes will only guarantee continued suffering among pizza lovers, say Leach. Further says Leach, “It’s time we move to a new model for pizza and start helping rather than hurting our customers.”
A federal court served up just deserts for some New York restaurants last week, ordering them to follow city regulations and post calorie counts alongside menu prices. Unfortunately, the restaurant industry appears determined to keep fighting and its legal battle to keep diners guessing is likely to go on.
In his ruling, Judge Richard Holwell of the District Court in Manhattan wisely noted that readily available calorie information might help control rampant obesity and knocked down the weird claim by the New York State Restaurant Association that the rules violate the First Amendment. The regulations are to go into effect this week. The industry has said it will appeal, shamelessly arguing that restaurants would suffer “irreparable harm.” That’s as rich as a McDonald’s large chocolate shake, which, by the way, has 1,160 calories.
The regulations apply to restaurants that are part of chains with 15 or more locations nationwide. About 10 percent of city restaurants, some 2,400, are affected. A few — including Starbucks, Quiznos, Subway, Chipotle, Auntie Anne’s, Jamba Juice and Chevys — are being responsible and voluntarily complying.
Others, like McDonald’s, Burger King, KFC, Domino’s, Pizza Hut and Taco Bell, are hold-outs. They must have missed the news that New Yorkers gained 10 million pounds over the last two years, disproportionately in poor and minority neighborhoods, where many of the 10 million chain-restaurant meals sold each month are consumed. Those neighborhoods are also where diabetes, hypertension and heart disease are at epidemic levels.
The industry maintains that calorie information is available online, and sometimes on place mats. That can be easily missed before diners order. New York’s pioneering effort should not be delayed any longer.
Kids who eat better perform better in school, a new study of Nova Scotia fifth-graders confirms.
Students who ate an adequate amount of fruit, vegetables, protein, fiber and other components of a healthy diet were significantly less likely to fail a literacy test, Dr. Paul J. Veugelers of the University of Alberta in Edmonton and colleagues found.
While a healthy diet is generally assumed to be important for good school performance, there has actually been little research on this topic, Veugelers and his colleagues note. To investigate, they looked at 4,589 fifth-graders participating in the Children’s Lifestyle and School-performance Study, 875 (19.1 percent) of whom had failed an elementary literacy assessment.
The better a student’s eating habits based on several measures of diet quality, including adequacy and variety, the less likely he or she was to have failed the test, the researchers found, even after they adjusted the data for the effects of parental income and education, school, and sex. Eating plenty of fruit and vegetables, and getting fewer calories from fat, was also associated with a lower risk of failing the test.
To date, Veugelers and his team say, most research on diet and school performance has focused on the importance of eating breakfast, as well as the ill effects of hunger and malnutrition.
“This study extends current knowledge in this area by demonstrating the independent importance of overall diet quality to academic performance,” the researchers conclude.
“The consistency of this association across various indicators of diet quality gives emphasis to the importance of children’s nutrition not only at breakfast but throughout the day.”
Small changes in schools lead to big results when it comes to preventing childhood obesity, according to a study published in the April issue of Pediatrics. The school-based intervention, which reduced the incidence of overweight by 50 percent, offers a potential means of preventing childhood weight gain and obesity on a large scale.
“The increasing prevalence and serious consequences of childhood obesity have pushed us to find solutions that go beyond the clinic and reach greater numbers of children,” said lead author Gary Foster, Ph.D., director of the Center for Obesity Research and Education at Temple University. “We focused on school because children spend most of their lives there and eat at least one if not two meals there.”
The two-year study was conducted in 10 K-8 Philadelphia schools. Half the schools implemented a multi-faceted nutrition policy, including social marketing and family outreach, which was developed by The Food Trust, a non-profit organization committed to ensuring that everyone has access to affordable, nutritious food.
“We incorporated healthy eating into every part of the school day in order to have a greater impact on the students,” said Sandy Sherman, Ed.D., director of nutrition education at The Food Trust. “The intervention fundamentally changed the school environment.”
The other five schools served as a comparison. The study focused on 1,349 students in grades 4 through 6, and followed them for a two-year period, measuring weight, height and physical activity before and after.
The intervention, also called the School Nutrition Policy Initiative, included the following components: school self-assessment, nutrition education, nutrition policy, social marketing and parent outreach.
“Every member of the school community worked together to create a healthier environment,” said Sherman.
Nutrition policy
Soda was replaced with water, 100 percent fruit juice and low-fat milk. Snacks were capped at 7 grams of total fat, 2 grams of saturated fat, 360 milligrams of sodium and 15 grams of sugar per serving. Candy was eliminated from the school premises.
Nutrition education
Teachers received 10 hours of training in teaching nutrition, and students received 50 hours of nutrition education over the course of the year.
Social marketing
Kids were rewarded for healthy snacking and encouraged to save their appetites for healthy meals. Nutritious snacks and drinks earned them raffle tickets to win prizes.
Family outreach
Nutrition educators encouraged parents and students to purchase healthy snacks. Students were challenged to be less sedentary and more physically active, and to eat more fruits and vegetables.
For details on the School Nutrition Policy Initiative, go to www.thefoodtrust.org/php/programs/comp.school.nutrition.php
Only 7.5 percent of children became overweight in intervention schools, compared with 15 percent of children who became overweight in comparison schools. The intervention was even more effective in African American students, who were less likely to be overweight than those in the comparison schools after two years.
The results are particularly interesting for urban schools, where rates of childhood obesity are disproportionately higher than in suburban areas and greatly affected by the surrounding environment.
“In some inner-city neighborhoods, it’s safer to stay inside after school than to go outside and play. When money is tight, it’s cheaper to feed your kids convenience foods, which are usually higher in fat and calories. Multiple environmental factors are responsible for the childhood obesity epidemic,” said Foster.
Despite the success of the interventions, the fact that 7.5 percent of children in School Nutrition Policy Initiative schools still gained weight over the two-year period suggests that stronger or additional interventions are needed, such as more time spent on physical education, more aggressive nutrition policies, and interventions that target the environment outside of schools.
The researchers also recommend that prevention programs begin even earlier than 4th grade, as the prevalence of overweight children (BMI above the 85th percentile) in grades 4 through 6 is already high at 41.7 percent.
Temple and The Food Trust are currently working together on a corner store initiative, designed to improve the nutrition of food and snacks for sale at neighborhood stores.
Designing walkable communities is a cost-effective way to address the growing epidemic of obesity in the United States and cut down on harmful car emissions and pollution, a researcher told the American College of Sports Medicine’s 12th annual Health and Fitness Summit in Long Beach, California.
The problem, said Jim Sallis from San Diego State University, is that local zoning laws essentially prevent the development of walkable communities. “Zoning laws today,” he told Reuters Health, “really enforce the separation of uses; they are designed to move cars as quickly as possible — which is dangerous to pedestrians.”
Sallis recently took a tour with urban planners in a new development in San Diego designed to be walkable. “The developers told me they had to get 25 waivers from zoning laws to put in the development. All that kind of paperwork costs the developer time and money so it discourages them from building walkable neighborhoods,” Sallis said.
He encourages people to “be a voice for walkable neighborhoods and parks in your area and help change local zoning laws.”
Sallis would also like to dispel the misconception that walkable communities are more expensive to build. They aren’t, he said, noting that money spent on building, maintaining and expanding roadways could be re-allocated to building sidewalks and trails.
Walkable cities “have worked for thousands of years,” Sallis points out. The most walkable cities are on the east coast of the U.S. because they are older. “Any city built in the 1800s is likely to be walkable because everyone who lived there walked. Cities like Boston, Manhattan, Washington D.C., inner Baltimore, Savannah, Charleston, are all very walkable,” he noted.
In the west there are fewer walkable cities, except for Portland, which has made a concerted effort to make the city pedestrian-friendly, Sallis said. “Many years ago, Portland set up policies for transportation planning that make pedestrians a first priority, cyclists second, public transit riders third, and car drivers last. It’s now one of the most activity-friendly cities in the country.”
“The suburbs have really been designed to take away the option of walking to places; there are no sidewalks, everything is spread out, and there is really only one way to get around and that is by car,” according to Sallis.
The good news, he said, is that more and more communities are embracing the idea of becoming more activity-friendly by adopting “mixed-use” area laws.
