DON’T WAIT – ORGANIZE AND ADVOCATE! 10TH BIENNIAL CHILDHOOD OBESITY CONFERENCE

ANAHEIM, CA

JULY 17, 2019

Colin Schwartz, MPP

Deputy Director, Legislative Affairs

Center for Science in the Public Interest

Center for Science in the Public Interest (CSPI)

Since 1971, CSPI has worked to:Make it easier to eat healthfullyPrevent and mitigate diet- and obesity-related diseases

Our Strategies:National, state, local policyEducation (newsletter, social media)Advocacy (regulatory, legislative)Litigation

CSPI AccomplishmentsNutrition Facts labels on packaged foods

Added trans fat to labelsRemove trans fat from food supplyMenu labeling at chain restaurants, supermarkets, movie theaters Warning labels on alcoholic beveragesLitigation—ads, labels, trans fat, marketing to childrenReduce junk food marketing to kidsFunding for food safety and CDC's nutrition, physical activity, and obesity programFood Safety Modernization ActPassage of Healthy, Hunger-Free Kids Act

Soda and junk food out of school vending, a la carte, school stores, etc. & improve school meals

What are the school meals programs?

National School Lunch Program: nearly half of all children in the U.S. (more than 30 million).

School Breakfast Program: more than 14 million children.

Taxpayer investment in both programs over $16 billion in FY2019.

Meals, snacks, beverages must meet nutrition standards

Every 5 years Congress takes up Child Nutrition Reauthorization (CNR)

Importance of strong school nutrition standards for low-income children

Helps close the gap in healthier food access between higher and lower-income schools

Helps reduce stigma

Decreases obesity among low-income students

The majority of participants are low-income

School lunch: 73%

School breakfast: 85%

Participation is increasing among low-income children

School lunch: 15.5m in 2000 to 22m in 2017

School breakfast: 7.5m in 2000 to 12.4m in 2017

School lunch participation trends

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Total

Free

Paid

RP

Great Recession (Dec., 2007)

Updated Nutrition Standards (Sept., 2012)

Source: USDA Child Nutrition Tables

How are things going?

Virtually all school districts serving healthier lunches with more whole grains, fruits and vegetables, less salt and trans fat.

IMPORTANCE OF HHFKA

IMPORTANCE OF HHFKA

Impact of the Healthy, Hunger-Free Kids Act

Updated school meal and snack standards: prevent more than 2 million cases of childhood obesity and save $792 million over ten years.

The Healthy, Hunger-Free Kids Act is “one of the most important national obesity prevention policy achievements in recent decades.”

- Harvard School of Public Health, 2015

Impact of the Healthy, Hunger-Free Kids Act

Recent USDA study found: 23.6 percent increase of nutritional quality for lunches; 21.7 percent

increase for breakfast. The vast majority of schools (85 percent) met or were close to meeting

the first sodium-reduction target in SY 2014-2015. The majority of school meals met daily requirements for fruits (95 percent)

and vegetables (81 percent). Same amount of plate waste from before and after the updated standards. School meal participation was highest in schools that had the healthiest

meals.

SO HOW DID ADVOCATES DO IT?

CSPI case study on HHFKA

Provide an in-depth look into how HHFKA came to pass to inform other nutrition and public health policy advocacy initiatives

Case study covers 2003 to 2015

Focus on nutrition standards

https://cspinet.org/schoolfoodcasestudy

1990s: First identify the problem and the solution

Research

Childhood obesity increasing

Unhealthy school foods

Policy cost-effective, sustainable

Early advocacy success: 1994 CNR meals based on Dietary Guidelines for Americans

2000s: Tactics used leading up to HHFKA

Build consensus and coordinate action

Build momentum at national, state, and local level

CSPI cultivated interest and technical assistance to pass policies

Use the research for advocacy

Bring industry to the table

Diffuse opposition

2000s: Leading up to HHFKA

Competitive foods (snacks and beverages)

Congressional legislation (2005-2010)

Institute of Medicine report (2007)

USDA and CDC case studies, CSPI state report cards

Bipartisan and industry support by 2006

Amendment to 2007 farm bill

School meals

Bush Administration contracted Institute of Medicine report on school meals (released in 2009)

Moment of opportunity

Perfect storm

Nontraditional and new partners

Use of research

Funders

Communications

Getting HHFKA to the finish line

Challenges

Anti-hunger groups preferred House CNR bill

Senate CNR bill SNAP offset

How challenges have been resolved

Bridge organizations

Healthy, Hunger-Free Kids Act passes!

After the law passes: regulations and defense

Implementation and defense of HHFKA

Implementation

Comment on regulations

135,000 of the 138,000 comments on meal standards

240,000 of the 247,800 comments on competitive foods

Defense of HHFKA

Opposition

First came pizza as a vegetable

Defense of HHFKA

Additional opposition

Limits on french fries

Whole-grain rich requirement

Sodium reduction targets

Countering the opposition

Work with USDA and White House

Key takeaways

Key takeaways: Policy

National policy change often takes time

20 years leading up to HHFKA

State and local momentum

Passing legislation first step of the process: implementation and defense essential

Timing (and luck) plays a role: “All the stars aligning”

Key takeaways: Advocacy

Parents, concerned citizens, health professionals, and local leaders have power, but do not always realize it

Grassroots involvement essential

Mix of research and real-life success stories

Make up for limited resources through coalitions

Differences of opinion between allies as much of a barrier as opposition from legislators or industry

Key takeaways: Industry

Food industry not monolithic

Public health organizations can have different motives than industry, yet still work together

Advantage of national nutrition policy easier and less expensive for industry than different policies in states and localities

Industry can respond to changing demand

Company innovation: lowering sodium

Aramark

ConAgra Foods

Domino’s Pizza (Smart Slice)

General Mills

Kellogg’s

Kraft Foods

Mars

Nestlé

PepsiCo

Revolution Foods

Schwan’s Company

Unilever

And many more!

School innovation: lowering sodium

Recent USDA study

USDA released the Successful Approaches to Reduce Sodium in School Meals Study in June, 2019

A large variety of products that meet current sodium standards are available for use in school meals

Range of effective school strategies

Additional communication and guidance to support implementation of the sodium standards were the most frequently requested technical assistance resources:

Dissemination of research on the health impacts of sodium and sodium substitutes 

Enhanced planning and communication with all stakeholders for implementing future targets 

Communication materials for diverse audiences, including schools, cooks, and FSMCs 

Targeted resources for food preparation, infrastructure, and trainings 

WHOLE GRAIN INNOVATION

Where we are now?

USDA’s final rule:

Delayed the second sodium reduction targets from SY17-18 to SY24-25 (initially delayed to SY20-21) and eliminated target 3

Weakened the whole grain-rich requirement from 100% to 50% (initially proposed only extending waivers)

Allows 1% flavored milk (without calorie or sugar limits)

The final rule violates the law and is based on: National Academies of Science, Engineering, and Medicine (formerly, Institute of

Medicine) 2009 report: School Meals: Building Blocks for Healthy Children 2010-2015 Dietary Guidelines for Americans (adopted the NAM recommendations) The 2015-2020 DGAs reinforced the same recommendations

SODIUM TOLERABLE UPPER LIMIT: 1,900MG/2,200MG/2,300MG

SODIUM DRI REPORT

WHOLE GRAINS: WHOLE GRAINS AT LEAST ½ TOTAL GRAIN CONSUMPTION

HOW ARE WE USING THESE BEST PRACTICES TO COUNTER THE ROLLBACKS?

How are we using these best practices to counter the rollbacks?

Litigation

Child Nutrition Reauthorization

Raising awareness: ads, Congressional briefing

Lobbying

Sharing research

Grassroots mobilization

What can you do?

Take action: www.CSPInet.org/actionalerts

Pass state/local policy

Pass school district policy

Governor issue executive order

State agency guidance, memo, or formal communication

If you work with schools and/or companies:

Provide technical assistance, best practices for meeting sodium and whole grain-rich standards

Thank you!

Colin Schwartz, MPP

Deputy Director, Legislative Affairs

Center for Science in the Public Interest

cschwartz@cspinet.org