Local School Districts Facing Opposition To Healthy Food Campaign

There have been initiatives to get students to eat healthier for years. Although some programs have had success, those implemented in low-income areas have had more resistance not only from teachers, students but parents as well. We will discuss the attempted programs encouraging healthy eating, and the resistance from low income families.

Guest

Michelle Bell, district coordinator of Student Health Service for the Sweetwater District. She will focus on the approach to student wellness in high school students .

Dr. Karen Coleman, director of the Healthy ONES campaign, has done intervention programs in many schools, especially Lemon Grove, focusing on healthy eating patterns in 2nd, 3rd and 4th graders.

Read Transcript

ST. JOHN: You're listening to These Days on KPBS I'm Alison St. John in for Maureen Cavanaugh. Almost one in three children aged 2 through 19 in San Diego are overweight or obese. That's according to the San Diego County childhood obesity initiative. And more than a quarter of these children are showing symptoms of type two diabetes. We're going to talk about a couple of healthy food initiatives in San Diego schools, and why it's not just a matter of changing the menu, it's a matter of changing attitudes and cultural expectations about what's good to eat. There's resistance from students issue teachers, and even parents, and of course progress is also being made. So I'd like to welcome our guests of we have on the line, doctor Karen Coleman, doctor Coleman, thanks for being with us.

COLEMAN: Thank you for having me.

ST. JOHN: Doctor Coleman is director of the healthy ones campaign, and a research scientist for Kaiser Permanente. She's done intervention programs in several schools, especially Lemon Grove, focussing on healthy eating in 2nd, 3rd, and 4th grades. And then we also have Michelle Bell, thanks for coming in, Michelle.

BELL: Thank you.

ST. JOHN: Who is district coordinator of student health services for the sweet water district. She'll focus more on talking about high school students and I'd also like to hear from you. What do you think about what your kids are eating at school? Do you think schools should be doing more to improve student diets or are they going too far? 1-888-895-5727 is the number to call. So doctor Coleman, let's start, how do we know that eating the right stuff effects a child's ability to do well in school even?

COLEMAN: Well, there's mounting evidence, especially with respect to breakfast, that having a good healthy breakfast, something like oat meal, actually improves concentration and standardized test scores. Physical activity also has a lot to do with whether a child does well on a standardized test or not.

ST. JOHN: Now, the school district where you've been working in lemon grove, a hundred percent of the students are eligible for free and reduced lunch. How many of them are actually taking advantage of that?

COLEMAN: Most of them, actually. It's a fairly low income school district. It has a lot of immigrant families, black and Hispanic kids. So many -- almost all of them get some kind of school meal, breakfast or lunch.

ST. JOHN: And what are these children in these communities used to eat something.

COLEMAN: You mean at home?

ST. JOHN: Yes.

COLEMAN: It depends. I mean, there's a large number of different cultures. There are Somali immigrants in the community who are used to eating, you know, fruits and vegetables. But generally when they come to this country, the flutes and vegetables are not easily available, and so they eat a lot of processed foods. Most of these families are eating what's cheap and available and that tends not to be healthy.

ST. JOHN: So Michelle, in sweet water, do you have a similar situation there? What percentage are eligible for free and reduced lunch?

BELL: We have a population of about 43000 students and about 22000 of our kids qualify for free and reduced lunch. And that's about -- well, probably more qualify, probably more like 60 to 65 percent but we serve 22000 free and reduced lunches.

ST. JOHN: Huge number of children affected in sweet water, one of the largest districts in the state.

BELL: Correct.

MAUREEN CAVANAUGH: So what are the habits you're trying to break among the older students? . We're just trying to get them, like doctor Coleman said, to eat breakfast. A lot of our kids come to school, they stay up late, they get up late, they get to school late, and so they usually miss the opportunity to have breakfast. So we're trying to focus more on breakfast. We have, like, what we call is a nutrition break, so a break between the morning classes and lunch, so they can at least get something from our food carts or from our cafeteria during that time.

ST. JOHN: Okay, doctor Coleman, you're a researcher, and you've done a lot of research on what kind of interventions work in this headlight ones campaign. Tell us, what's your strategy to break unhealthy eating patterns?

COLEMAN: Well, we're concentrating on the school. So -- and trying to change the school environment. And actually, having the nutrition break brings up a good point in Lemon Grove, we try to institute fruit at recess to actually get a fruit snack into the kids during morning recess. And that's provided by the -- nutrition services at the district. And the kids actually participate in the process and get the fruit from the cafeteria, and they bring it out, and they actually serve it to their school mates. And we actually -- it's not a band, but we ask the teachers to make sure that the kids are not eating other things during that period of time, like their own lunches and hot Cheetohs and different things like that that they would normally eat. So they only eat the fruit snack, and they end up playing a lot more because they're not all sitting around on the playground sharing bags of chips and soda and things like that. So that's one thing that we've tried to do. And then --

MAUREEN CAVANAUGH: And just a quick question, how's that going? Do they take to it.

COLEMAN: It's great. Yeah, the kids love it. It gives the kids a sense of accomplishment, and they get to learn a little more about nutrition services and how they prepare food. And the things that are important or food safety handling and different things like that. So it's been a great success. And it's -- we didn't plan it this way, but it's ended up increasing the amount of physical activity that happens during recess which we thought was a really nice bonus.

MAUREEN CAVANAUGH: So now, Michelle, how has it been going for older kids? Do you think it's perhaps easier for younger kids to break habits and you're face a little bit more of a challenge with older kids?

BELL: Yeah, I think in elementary school, it's maybe a tad bit easier if they have good role models. And I think where they have more of a challenge is focussing on parents.

COLEMAN: Yes.

BELL: Because parents need to make changes in order for the kids to make the changes, where in the secondary level, kids are expanding out onto their own, they're developing their own sense of self. And so if you can have strong role models at school, then I think kids pick up on that. So if they have a particular coach that eats healthy or in our district, we're lucky enough to have 25 nurses full time. So we have one nurse in every school site. So in order for people to be out and amongst the campus, modelling healthy behavior, I think that really plays a big part in changing the cultural and middle school and high school.

ST. JOHN: Okay. I wanted just to bring in a celebrity, we've -- many of us, you certainly, Michelle, said that you've heard of Jamie Oliver, who's a British celebrity chef who's been taking Los Angeles by storm. He's been trying to change eating habits of kids of all backgrounds, and he's trying to find ways to make healthier food desirable to young children. And we have a chip from him on a YouTube video where he's showing children the painful and quite disgusting way of making a chicken McNugget. But even if they've seen this, are the children are still saying they want the nuggets of soap here's the clip of the children's response. And Jamie's frustration.

(Audio Clip:)

OLIVER: Do you think that's good food for you or bad food?

KIDS: Bad food.

COLEMAN: Why would you still eat it if you know it's bad?

KIDS: 'Cause we're hungry. I'm just hungry.

OLIVER: What's scary is we've brain washed our kids so brilliantly, so even they know something is disgusting and gross, they'll still eat it if it's in that friendly little shape. There you go. It pains me to give you them.

(End Audio Clip)

MAUREEN CAVANAUGH: So Karen, what's your reaction to that?

COLEMAN: Well, you know, Jamie Oliver has probably done more for the school food revolution than anyone. But I -- I really -- I remember seeing a clip of his, this is in the same vain of these chicken McNuggets where he was talking to the nutrition services staff, doing the exact same thing. Where, do you think these are healthy? Would you eat them yourself? Why would you serve them to the kids? It's very negative. And it puts people's backs up. And he has not been able to get into Los Angeles unified school district, nor has he been able to make headway in any cool districts, and the reason for that is because he puts them on guard. You know, one of the approaches this we tried to use was to treat the nutrition services like health educators, you know, like teachers. And we tried to have a partnership with them, and make them feel like they really could have a voice in the changes that they made. And so we didn't go in and tell them that, you know, they were poisoning the children by serving them this food. They don't -- they want the kids to eat healthy meals. No one wants to poison the kids of but by doing that, he's alienated the staff and they're not going to change.

ST. JOHN: So it might make for good reality TV, but it's not helping the schools.

COLEMAN: It's not. And they're reacting to him. They're not letting him in. And you know, what good does that do?

ST. JOHN: So let's move on to talking about -- he was looking at the resistance of the students. But you're also saying the parents are getting upset about some of the changes in food in schools. How are you approaching -- what is this struggle and how are you approaching it.

COLEMAN: Well, we -- so we want -- schools are about providing a safe and healthy environment in which the kids can learn. And they do a lot of things around that goal which they don't allow weapons on campus, they don't allow the kids to wear logo line clothes, different colors, different things like that that might make it an unsafe environment, and so we asked the schools to ask the parents not to send junk food to school with the kids and also not to have cup cakes for parties and cakes for celebrations and fundraisers and things like that. And we did -- we got a lot of backlash from the parents. And most of it was around the fact that you can't tell me how to feed my child, that the -- you know, the government needs to stay out might have business. This is my choice. And actually what happens is if you send cup cakes to the school, and the entire class eats those cup cakes, it's not just a choice for your child. You're choosing for other people's children as well. And so there are enough parents also upset with their child having to eat a cup cake, because it's hard for a child to say no when they're in that situation so much we just worked with the parents to help educate them about what we were trying to do, and it took a long time, but through PTAs and English as a second language, and some parents that were very vocal critics of the intervention, we actually invited them to be part of the planning, and so they ended up being champions for it. It just takes a lot of time, and it takes administration that's willing to put up with parent complaints.

ST. JOHN: 1-888-895-5727 is the number to join the conversation. What's going on in your child's school? Do you think that schools should be doing more to improve student diets or is that not their job? So did you find that there was any kind of cultural issues too in the -- you mentioned Somali kids before, but changing the kind of food that people are used to eating?

COLEMAN: Well, we're not -- we did not target the home environment. So we were just trying to make the cafeteria meals as healthy as possible, and to incorporate more fruits and vegetables. And fruits and vegetables are actually a part of every culture that comes to the U.S. it's only when they come to the U.S. that they lose their fruits and vegetables. But there is a cultural defense in how parents get involved in schools. And many immigrant communities are not very trustful of government institutions, so they tend not to get involved in school related things, and they also expect the school not to get involved in their personal parenting business, so it's extremely difficult to get parents involved in anything in some of these low income immigrant communities. And then parents are working. It's more a culture of poverty than it is anything else. And so that's what we fight against, helping parents to understand that they can afford to buy healthy snacks, and it's important that they get involved in the school practices, and that the school actually work for the parents. It's not the other way around.

ST. JOHN: So Michelle, you've seen some of this in sweet water too, have you? That issue of sometimes the unhealthier foods are the cheaper food of so that is an issue for some families of what are you seeing in sweet water?

BELL: It is, I think we're seeing the similar things between the elementary schools and the high school districts, and again, it does take a lot of patience. Doctor Coleman's right. You have to have agencies that are willing to partner with districts like hospitals and community clinics so that parents have a trust base that the information that they're hearing is accurate and correct. And that you're not just trying to scare them. So I mean, we do see similar things but I think we need to work closely together between the elementary districts and the high school districts. And I think in sweet water, we're doing that. Our elementary districts are really working hard to target childhood obesity, to look at what it is that we're feeding our kids in the elementary district, and then what we're feeding our kids in the high school district.

ST. JOHN: 1-888-895-5727 to join the conversation with doctor Karen Coleman issue director of the healthy ones campaign, and a research scientist for Kaiser Permanente, and Michelle belle who's coordinator of the student health services for Sweetwater. And Angie is on the line with a point to make. Thanks for joining us, Angie.

NEW SPEAKER: Hi, thanks for having me. I just wanted to make a quick comment. Myself and a group of graduate students who are at San Diego state university, we have a couple public health students and a couple -- I myself am a masters of nutrition student, and we have been fortunate enough to be able to team up with the childhood obesity initiative and work down in sweet water's union at sin Ysidro's high school, with a group of students there. And we've been very successful in being able to implement some positive, some more nutritious foods on the breakfast and the lunch school menus. And you had mentioned, you know, Jamie Oliver kind of uses the tactic of coming in and sort of setting everybody on edge. Of and we've been hugely successful mostly because we have been -- for lack of a better word, friendly with everyone. We've been able to get the principle on our side, the director of food services, the cafeteria manager, and we've been able to work together to get those changes made. And I just think it's important to point out that those changes are being made, and that there's good things going on too.

ST. JOHN: Angie, thanks for that call. We've got some nodding going on here. Michelle, do you have a reaction to that?

BELL: Yes, actually the San Diego State project out in San Ysidro High school has been going quite well, but it was a little rocky in the beginning, and the director of food services has been spending quite a bit of time out there with the principle, with the students, with a couple of their teachers. Myself, one of the students that's actually participating in that project sits on my wellness community. Soap we are trying to embrace everybody's needs and listen to everybody's concerns in order to try to get those foods on the menus that kids really want. Now, food services, and I, we would like to get rid of hot cheatos of as a nurse, I don't really find the value in them. But you have to make compromises, so if we can get Turkey wraps and we can get freshly made salads, and the kids are weighing those, and the school's making money, then maybe teaching kids how to better eat hot cheatos, maybe one time a week versus five times a week, then that's a concession that we as adults within the district can make.

MAUREEN CAVANAUGH: Okay. And Karen, have you found that there's a good strategy for getting parents and students involved, and have you had to make compromises? What kind of compromise it's --

COLEMAN: Oh, yeah, you always -- we have a different model of doing school based research, which is based on community based participatory research principles. And essentially, we come into the school as experts in knowing kind of what will work, but it's about a partnership. And so it takes a really long time 678 I know Michelle really highlighted that, where the 50 part of any type of intervention and very -- it's very -- it can be very contentious. And so you just have to let them know that you're here to support them, and these are the things that we know will work. But so fruits -- we know fruits and vegetables, more of them reduce obesity, you know, heart disease, all the different things that are good about them. Of but how to get them into the school meals, and get them as snacks and different things at home, that may vary from one school to another. And so we try not to be so inflexible with what we do. Of and so we do have compromises and I think that the data that we collect, we are doing obesity rates, but because it takes a good year or two years sometimes to really get the schools on board and to get the policy changes and to work through all the things that the parents have objections to in the food services staff, and the caf -- you know, we work with custodians, we work with teachers, it takes a really long time to get it off the ground and get it running successfully.

ST. JOHN: Well, one of the points that actually Jamie Oliver brought up in his clip was that the kids just like those chicken McNuggets because of the cute little shape. Is that something that you found.

COLEMAN: Sure.

MAUREEN CAVANAUGH: ? The way you present the fruit and vegetables is important?

COLEMAN: Yeah, you know, we've done most -- in Lemon Grove school district, every school has a salad bar. And they had that before we started. But the salad bars are difficult for little kids. They can't use the tongs, they didn't cut the fruit so they just gave them whole apples and for little kids, that's completely overwhelming. They can't peel an orange by themselves. So we actually worked with it, we bought all the cafeterias that were in the intervention schools cutters, industrial sized cutters so that they would cut the fruit and it was more efficient. We spent days in their cafeteria trying to figure out how to put lemon juice on the fruit so it wouldn't brown so it would still look good, because the kids won't eat the brown fruit. We put it in little tiny cups, they like little things so much we made signs with colors ask all kinds of different stuff to try to get them -- we hid the vegetables in the food and didn't tell the kids of that's actually a very good strategy.

ST. JOHN: Where's a recipe that you can do that in.

COLEMAN: Well, you can put call flower in macaroni and cheese. And it doesn't change the color, and it adds texture to it, so it's actually much creamier. We also did -- we did put broccoli in the macaroni and cheese, and the kids called it pesto pasta. And so we just worked with them to market it a little differently. And one of the things that was successful for us was that we tried things for a short period of time. So we got rid of the self serve condiments where they put ranch dressing all over their pizza. And the cafeteria staff thought that that would ruin their lunch, and the kids would complaining. And actually what happened was that the kids were mad about it being gone for 2 or 3 days but then they just forgot about it.

MAUREEN CAVANAUGH: That's so interesting. So you're making the point that it might be a bit about marketing a little bit too.

COLEMAN: Oh, totally.

BELL: It is, totally.

ST. JOHN: For Little kids, probably what is cool to be seen eating --

BELL: And for us, that's kind of where we've made our modifications in the schools where -- radio right now we're maybe a little bit more than half of revamping all of our cafeterias word process the district. And part of what our director of food services, and -- be is the marketing approach, and what she decided to do was make our cafeterias look a little bit more like food courts and have appetizing menus, and come up with creative names so we have, like, doctor smoothy PhD. Of course we have the dean of greens for our soup and salad bars of weep actually have shakers for our salad, so it's already in -- we make them up in the morning but then the kids can just shake the salad dressing on it, instead of pureeing it all over. You know, because that's kind of what they're used to. When you have a full salad bar that you can just pick your amounts and pure stuff over, it's not necessarily healthy. But when it comes in premeasured cups and the dressing is only enough to coat your lettuce, barely coats it, so you get the flavor of the actual lettuce versus the flavor of salad dressing, it seems to make more of an impact. So having kids, that's the other thing, our associated student body is working with food services to actually benefit in the money making aspect of it as well. Before our student bodies used to get money from selling chips and sodas and that kind of stuff for student programs. Now that work with the food services, the cafeteria managers to actually recoop some of the money that the food sales are bringing into the school.

MAUREEN CAVANAUGH: Okay. Good. Will so we only have a minute left but I wanted just to make the point, Karen, that you tried to get the board education to ban unhealthy snacks and even those brought from home, and that didn't work so well, did it.

COLEMAN: It didn't, not as an official policy, no, but what happened was we ended up having the individual principles, and teachers, get on board and so they slowly but surely -- we were able to reduce the junk food to almost 0 by just working with individual champions at will 62. But yeah, the school district supervisor would not adopt that as a policy.

MAUREEN CAVANAUGH: Okay. It's quite a challenge, isn't it? Changing habits on food. But I'd like to thank you both for joining us, doctor Karen Coleman of the healthy ones campaign. Thanks for being with us, doctor Coleman.