WEBVTT

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Prof: Welcome everybody.

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I was just curious,
how many of you guys would be

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up at this hour anyway if it
weren't for this class?

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About six it looks like--;well,
I'm happy I could help the rest

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of you be up early in the
morning like Ben Franklin says,

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it's good for you.

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Before I introduce today's
guest speaker,

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I wanted to announce that
Monday we'll have a guest

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lecturer as well,
somebody that you'll really

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want to see.

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His name is Brian Wansink.

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Brian is a Professor at Cornell
University,

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a professor of marketing,
and has done a tremendous

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number of very interesting
studies about the factors that

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drive what people eat.

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Factors like the size of the
portions,

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how much is in a container,
the shape of glasses and things

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like this that end up in the
press a good bit,

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so you probably about his work
already.

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He wrote a book called
Mindless Eating that has

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received a lot of attention and
so he'll be very interesting to

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hear from based on his own
research.

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Then in addition to that,
Brian was recruited to the

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U.S. Department of Agriculture
to take a high position in a

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part of the USDA that
establishes nutrition policy.

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It'll be very interesting to
hear him discuss how his

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academic and scholarly work
comes together with public

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policy.

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In addition to that he is a
very engaging speaker,

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so I'm sure you'll like him.

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I'm very happy today to
introduce a colleague of mine,

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Dr. Marlene Schwartz.

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Marlene is the Deputy Director
of The Rudd Center for Food

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Policy and Obesity,
and in that position has a key

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role in establishing the
direction of The Rudd Center and

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coordinates essentially all the
activities of The Rudd Center.

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She was trained at Yale
University,

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has a PhD in clinical
psychology from Yale,

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spent a number of years as
Director of The Yale Center for

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Eating and Weight Disorders.

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So in addition to the work that
she's going to talk about in

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schools today,
she's an expert on the

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treatment of eating disorders,
obesity, and various body image

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related issues.

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Then in more recent years,
has become very interested in

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children's nutrition,
parents' role in shaping their

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children's nutrition and the
schools,

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and has been very heavily
involved in the national scene

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about schools and nutrition.

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In the state of Connecticut,
as I mentioned before,

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we have the strongest school
nutrition legislation in the

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country.

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Marlene was very involved in
providing the academic and

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scholarly basis for that public
policy.

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She's asked to consult around
the country on various school

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nutrition related issues and
she'll probably talk today about

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her work on school nutrition
wellness policies,

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school wellness policies.

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There's an interesting history
having to do with federal

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legislation and what actually
happens on the ground in schools

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with this,
and Marlene's work has been

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used for the basis of a number
of interesting decisions

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regarding school nutrition
around the country.

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It just so happens that a
number of you--and I'm very

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grateful for all you guys
sending me articles that you see

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and video clips and things like
that,

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which are really nice--a number
of you sent me an article that

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was in The New York Times
on Monday and it was on schools

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and nutrition,
and Marlene was quoted in that

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article.

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Let's please welcome
Dr. Marlene Schwartz.

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As Kelly said,
I was trained here at Yale

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University.

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What he didn't mention is I was
trained here at Yale University

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by him,
and so what you'll notice as I

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go through my work,
is it probably will seem very

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familiar to you in terms of the
way that I think about research

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and the way I think about
combining research with public

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policy.

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What I'll be talking about
today is a little of history

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about regulating school food.

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Even though it's something that
seems to be a new issue,

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it actually goes back quite a
few decades, and I think it's

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good to have that perspective.

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Secondly, I'll be reviewing
some of the research on how

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school food influences student
nutrition and health.

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I'm going to give you a little
directory of who's who in the

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school food movement in the
United States and in the UK,

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and then share some of my own
experiences in the process of

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trying to make local changes,
and then discuss in more detail

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this newer phenomenon of school
wellness policies.

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One of the questions that I
often get asked when people know

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that I care about childhood
obesity, is: why are you

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focusing specifically on
schools?

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There's some pretty clear
answers to that question.

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First, it's where the kids are,
so they have access to 95% of

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all American children,
and The National School Lunch

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Program serves 29 million
children each day,

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so if you can make a change in
The National School Lunch

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Program,
you're going to immediately

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affect the intake of millions of
children.

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They also are subject to both
federal and state regulation,

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which means from a policy
perspective there are a couple

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of avenues through which you can
try to make changes in the

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school system.

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Another thing is I feel like
schools have a precedent for

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setting higher safety and health
standards.

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I often give the example that
when I was in high school we had

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a smoking area specifically for
students,

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where if your parents signed a
permission slip you were allowed

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to go and smoke during the
school day.

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That was one of the first
things that was banned,

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and that had to be done well
before we started seeing things

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like no smoking in restaurants
or other public buildings.

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Finally, schools are really the
ideal setting where you can

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combine education with the
environment,

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and sort of teach children
about nutrition,

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but then help them sort of live
the lessons that you're teaching

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them while they are eating at
school.

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In terms of the history,
this may come as a surprise to

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you,
you may have not such terrific

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memories of school lunch,
but the official school

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lunch--the thing that had all
the different components,

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the protein,
the grain, the fruit,

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the vegetable,
and the milk has always been

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required to meet certain
nutrition guidelines.

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So there really were rules
about the chili dog or the

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chicken nuggets,
where that meal did have to

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come together and meet these
guidelines which originated

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back--The National School Lunch
Program was originated in 1946,

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and The Breakfast Program in
1966.

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School meals have to cover
one-third of the recommended

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daily allowance for calories,
protein, and several vitamins,

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and iron, and calcium.

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They also are legally supposed
to have fewer the 30% of their

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calories from fat and fewer than
10% of their calories from

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saturated fat.

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People sometimes find that hard
to believe, but those are the

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guidelines that food service
directors are required to

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follow.

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The problem has been what's
called competitive foods.

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Those are the foods that are
sold in addition to the school

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lunch in the cafeteria.

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As many of you probably
remember, in the school

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cafeteria,
you had sort of the official

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lunch of the day but then there
were often other snacks or

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beverages,
or just one component of the

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lunch like one hamburger,
or just French fries that you

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could buy separately.

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Those are all competitive foods
because they compete with the

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full school lunch.

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These competitive foods started
coming into schools in the late

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1960s.

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In 1970 the USDA were concerned
that some of these competitive

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foods were being sold by people
other than the school lunch

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program,
and so they were essentially

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taking money away from the
school lunch program.

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They proposed that any food
offered at school,

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during lunch,
could only be sold by the

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program.

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What that meant is that other
groups like clubs,

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or the PTA, or things like
that, were not allowed to do any

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type of fundraising during the
lunch period,

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either through vending through
school stores,

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bake sales, things like that.

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Well, in 1972 there was a lot
of controversy about this,

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and the federal authority from
the USDA to set this regulation

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was actually removed,
and was given instead to the

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states.

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At that point states could set
their own guidelines for whether

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or not other foods were allowed
to be sold in competition with

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school lunch.

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This was helpful for the people
who wanted to do fundraising

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during school,
so these other organizations

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could then sell food during
lunch,

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and get money for their causes
from the students.

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However, then there was a
concern that there were very

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inconsistent state standards,
so in some states the school

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lunch had no competition,
in other states there was a lot

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of competition.

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So in the late 1970s,
the USDA got their authority

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back.

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They introduced this concept of
foods of minimal nutritional

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value,
which is a term that you hear a

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lot when you start really
getting into the trenches with

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the school lunch.

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These are foods that are
defined because they contribute

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less than 5% of the recommended
daily allowance of certain

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important nutrients,
and they fall into four

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categories.

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They fall into candy,
soda/water, frozen desserts,

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and chewing gum.

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In 1980, the USDA decided that
these foods of minimal

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nutritional value,
which include soft drinks and

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candy,
were prohibited anywhere in the

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school until after the last
lunch.

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They were trying again to sort
to clear out the cafeteria from

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these other foods.

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In doing so,
make sure that kids were more

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likely to buy the lunch.

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The health advocates didn't
like this, because they felt it

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wasn't restrictive enough.

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They wanted those foods out of
the building entirely.

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But The National Soft Drink
Association on the other hand,

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thought they were too
restrictive.

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They said that the USDA was
taking advantage of their power

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and this law was arbitrary,
capricious and abusive

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discretion and otherwise not in
accordance to the law.

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S they filed a lawsuit and they
requested a preliminary

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injunction meaning that they
didn't want this law to go into

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effect until they had a chance
to appeal it.

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In June of 1980,
the district court denied that

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request, they appealed,
and in 1983 the U.S. Court of

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Appeals overturned the time and
place portion of the role.

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What that means is that they
said in fact these foods--those

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soft drinks would be sold in
schools.

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In 1984, they finally said that
those foods of minimal

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nutritional value couldn't be
sold during the meals,

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but they could be sold before
and after the lunch period.

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That's pretty much how things
have been since 1984.

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Right now the situation is that
during the school lunch period

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the school can sell these--the
regular lunch,

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they can sell some of these
sort of snack items but not the

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foods of minimal nutritional
value.

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Those can only be sold early
before the lunches start,

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and later after all the lunches
finish.

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One of the things that's been
talked about a lot is that we

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need an expanded definition of
foods of minimal nutritional

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value.

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I have this list up here,
and if you just want to take a

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moment and just jot down which
one you personally would

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consider junk food.

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What do you think is a food of
minimal nutritional value?

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Then, I'm going to show you
which ones technically are foods

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of minimal nutritional value.

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What's striking about this is
what's not: so French fries,

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ice cream, candy bars,
cookies, chips,

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snack cakes,
and donuts are all not

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considered foods of minimal
nutritional value.

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In other words,
those can be sold during the

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school day, and are not
considered a food that is not a

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healthy choice for a child.

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Clearly this list needs to be
updated.

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What does the school food
environment look like right now?

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Well I quote Kelly who said,
"It's a 7-Eleven with

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books," in testimony to the
U.S. Senate.

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In fact, it is remarkably like
that.

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If you--this was from 2004,
there was a study looking

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across the country to look at
the competitive foods across

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elementary, middle,
and high schools.

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What's striking about this is
if you look at the vending

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category in the high schools,
which is in sort of the

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blue/green color,
you can see that over 90% of

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American high schools have
vending machines in their

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schools, so this is a huge,
huge issue.

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Now what I think is interesting
is when you look at that

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environment,
having the vending machines in

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your high schools,
and how consumption of milk and

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soft drinks have changed over
time for American teenagers.

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These are some data from the
USDA, and you can see back in

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the late 1970s,
boys had about 15 drinks of

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milk a week,
girls about 10,

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and then both boys and girls
had about seven drinks a week of

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soft drinks.

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By the mid-1990s you can see
that milk consumption had

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significantly dropped and soft
drink consumption had

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significantly increased.

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You've got boys--teenage boys
tend to be some of the highest

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consumers of soft drinks--is up
to 20 beverages a week,

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so clearly there's been a
significant shift in what

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teenagers are drinking.

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I would argue it's because back
in 1970s the only thing you had

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to drink was milk or water from
the water fountain,

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whereas, by the mid-1990s,
90% plus of these schools had

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vending machines that sold soft
drinks.

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Now I'm going to give you a
sneak preview of your speaker on

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Monday,
Brian Wansink,

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because he did a study which
has actually been very

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influential in my own thinking
of how to change the school

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environment.

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What he did,
is he went into office

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buildings with bowls of
M&M's.

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He's actually done a lot of
M&M studies,

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which he'll probably share with
you next week;

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but this was one of the M&M
studies where he had bowls of

13:37.940 --> 13:41.770
M&M's and in some offices,
he put the M&M's on the

13:41.765 --> 13:42.285
desk.

13:42.288 --> 13:45.478
In other offices he put the
bowl of M&M's over on the

13:45.480 --> 13:47.630
printer stand,
which as you could see was

13:47.628 --> 13:50.028
maybe a foot and a half away
from where the person was

13:50.030 --> 13:50.530
sitting.

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Then he--and maybe his students
snuck into office buildings at

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night and looked to see how many
M&M's were left in the bowls

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from these different locations.

13:58.700 --> 14:01.930
Amazingly, what they found was
that if your M&M's were

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right in front of you where you
could just reach out and get

14:05.282 --> 14:07.122
them,
you were significantly more

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likely to eat those M&M's
than if you had to actually get

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up and take two steps to your
printer stand and get them over

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there.

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What's interesting about this
is it shows how very subtle

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changes in the environment--I
mean you don't think of that as

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being a major difference in
terms of your access to

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M&M's,
can actually significantly

14:23.784 --> 14:27.464
influence how many of something
you'll eat and how quickly you

14:27.456 --> 14:28.356
will eat it.

14:28.360 --> 14:33.090
Another thing that's also
infiltrated the schools is the

14:33.085 --> 14:36.775
use of food as a reward in the
classroom.

14:36.779 --> 14:38.419
This is just an example.

14:38.418 --> 14:41.538
This was a program from Dunkin'
Donuts where they told teachers

14:41.543 --> 14:43.813
that if their students did their
homework,

14:43.808 --> 14:45.988
they should hand out these
coupons which were good for two

14:45.985 --> 14:46.515
free donuts.

14:46.519 --> 14:49.769
In addition to the physical
food that's being sold,

14:49.769 --> 14:52.779
there's also been an effort on
the part of the food industry to

14:52.784 --> 14:55.464
get their product sort of
advertised and promoted within

14:55.461 --> 14:56.581
the school setting.

14:56.580 --> 14:59.240
What influence does this have?

14:59.240 --> 15:02.260
How does the environment
influence student nutrition and

15:02.264 --> 15:02.764
health?

15:02.759 --> 15:06.049
Well, there have been a bunch
of studies looking at the school

15:06.054 --> 15:09.084
environment and what changes it
seems to make in terms of

15:09.081 --> 15:10.271
student nutrition.

15:10.269 --> 15:13.619
One of them found that students
who choose The National School

15:13.615 --> 15:16.905
Lunch actually eat two times as
many fruits and vegetables as

15:16.908 --> 15:18.168
children who don't.

15:18.168 --> 15:20.818
This is interesting because
again, The National School Lunch

15:20.817 --> 15:23.737
has a pretty bad reputation,
but what they found was that if

15:23.743 --> 15:26.403
you did order the lunch,
which by law has to offer a

15:26.400 --> 15:29.010
fruit and a vegetable,
you were better off than if you

15:29.006 --> 15:31.646
just bought the a la carte items
or even if you brought your

15:31.649 --> 15:32.499
lunch from home.

15:32.500 --> 15:34.960
There's also been research
showing that as students

15:34.958 --> 15:36.778
transition from elementary
school,

15:36.779 --> 15:39.019
which tends to have fewer
competitive foods to middle

15:39.024 --> 15:41.404
school where there are more,
their diet deteriorates.

15:41.399 --> 15:44.829
They'll eat fewer fruits,
non-fried vegetables,

15:44.831 --> 15:47.891
less milk and more sweetened
beverages.

15:47.889 --> 15:50.769
Again, this was just another
way of documenting how the

15:50.772 --> 15:53.442
environment can really
significantly change the way

15:53.442 --> 15:54.512
kids are eating.

15:54.509 --> 15:57.849
There's been some research
looking at schools that don't

15:57.854 --> 16:00.534
have the a la carte or
competitive foods,

16:00.528 --> 16:02.708
and they found that the
students in those schools eat

16:02.710 --> 16:05.100
more fruits and vegetables and
fewer calories from fat.

16:05.100 --> 16:08.310
Finally, one of the studies
that I find most convincing is

16:08.312 --> 16:11.022
one that looked at high
schools--this was done in

16:11.017 --> 16:14.507
Minnesota and they interviewed
high school principals and asked

16:14.510 --> 16:17.950
them about the types of policies
they had that limited student

16:17.948 --> 16:21.388
access and consumption of foods,
so these were things like

16:21.392 --> 16:23.842
having a closed campus as
opposed to an open campus,

16:23.840 --> 16:26.250
whether or not they allowed
eating in the classroom,

16:26.250 --> 16:27.540
whether or not they allowed
eating in the hallway,

16:27.538 --> 16:28.038
things like that.

16:28.038 --> 16:31.538
What they found is that the
schools that had more policies

16:31.544 --> 16:34.874
to limit consumption actually
had a lower prevalence of

16:34.865 --> 16:38.675
obesity then the schools that
had fewer of those policies.

16:38.678 --> 16:41.528
This is a really interesting
study because unlike just the

16:41.533 --> 16:44.093
others that look more at
behavior, this one actually

16:44.086 --> 16:45.836
found a link to student weight.

16:45.840 --> 16:48.900
In addition to those,
there have been a number of

16:48.898 --> 16:52.078
large-scale studies that have
tried to go in and do

16:52.083 --> 16:55.843
interventions at the school
level to see if they can have an

16:55.842 --> 16:58.012
influence on student weight.

16:58.009 --> 17:01.269
These tend to include things
like nutrition and physical

17:01.268 --> 17:03.898
education;
teaching the people working in

17:03.897 --> 17:07.027
the cafeteria to do different
types of cooking,

17:07.028 --> 17:09.618
so for example,
to use low fat cooking methods

17:09.615 --> 17:12.025
or switch to low fat versions of
foods,

17:12.028 --> 17:16.218
ideas on increasing more
physical activity in schools,

17:16.220 --> 17:19.680
so different types of ways to
get kids moving in the classroom

17:19.682 --> 17:21.332
so it's not just about P.E.

17:21.328 --> 17:24.438
A lot of these programs include
communication with parents about

17:24.439 --> 17:25.919
the importance of nutrition.

17:25.920 --> 17:29.490
Then the two specific things
that have gotten quite a bit of

17:29.488 --> 17:32.328
research attention is
recommending that students

17:32.329 --> 17:34.749
decrease their television
watching,

17:34.750 --> 17:37.700
because that's been shown to be
an important predictor of body

17:37.695 --> 17:39.295
weight,
and also recommending that

17:39.304 --> 17:41.384
students decrease their soft
drink consumption.

17:41.380 --> 17:44.880
When you look at the literature
as a whole, there have been

17:44.880 --> 17:48.200
behavior changes documented in
many of these studies.

17:48.200 --> 17:52.150
However, the research hasn't
found that many strong changes

17:52.147 --> 17:55.347
in body mass index or in other
types of physical

17:55.346 --> 17:57.386
measures--health measures.

17:57.390 --> 17:59.720
The field, I think,
has been kind of frustrated

17:59.720 --> 18:02.610
because a lot of effort has gone
into doing these sorts of

18:02.608 --> 18:05.398
interventions and the findings
haven't been as strong as

18:05.395 --> 18:07.165
researchers would have liked.

18:07.170 --> 18:10.600
One thing that came through is
that the best predictors of

18:10.596 --> 18:13.836
seeing a change in body mass
index were decreasing soda

18:13.843 --> 18:16.973
consumption, and decreasing
television watching.

18:16.970 --> 18:20.830
Then very recently a researcher
named Gary Foster who's at

18:20.827 --> 18:23.597
Temple University,
published a study he did in

18:23.603 --> 18:25.763
Philadelphia with middle school
students,

18:25.759 --> 18:28.459
where he found that if you go
in and make a lot of these

18:28.461 --> 18:30.281
substantial environmental
changes,

18:30.278 --> 18:33.478
he was able to document that he
could prevent the onset of

18:33.477 --> 18:36.957
overweight in the students--in
the middle schools that got this

18:36.955 --> 18:37.905
intervention.

18:37.910 --> 18:40.130
So in other words,
there was sort of the average

18:40.125 --> 18:43.045
rate of overweight that was
going to happen in both schools.

18:43.048 --> 18:45.808
In the intervention school,
he was able to decrease the

18:45.813 --> 18:48.833
number of students who became
overweight in the two years of

18:48.832 --> 18:49.602
this study.

18:49.598 --> 18:51.638
He was also,
and this is really important,

18:51.640 --> 18:54.380
able to show that he could
reduce the number of students

18:54.377 --> 18:56.117
who developed Type II Diabetes.

18:56.118 --> 18:59.598
It's interesting that this more
recent study has been able to

18:59.604 --> 19:02.374
show an effect,
and so I think that researchers

19:02.368 --> 19:04.308
have gotten better at
assessment,

19:04.308 --> 19:06.388
gotten better at doing some of
these programs,

19:06.390 --> 19:08.970
and have really in this study
in particular,

19:08.970 --> 19:11.830
had very strong policies as
part of the program in terms of

19:11.827 --> 19:13.797
what they could provide in the
school.

19:13.798 --> 19:20.098
Here's a--sort of a quick tour
of who's who on the school food

19:20.103 --> 19:20.933
issue.

19:20.930 --> 19:24.140
This is Jamie Oliver,
and you all--some of you may be

19:24.143 --> 19:25.383
familiar with him.

19:25.380 --> 19:28.200
He goes under the name The
Naked Chef and he has a lot of

19:28.195 --> 19:28.795
cookbooks.

19:28.798 --> 19:33.858
A few years ago he learned
about the school food in the UK

19:33.864 --> 19:35.734
and he was furious.

19:35.730 --> 19:37.690
He thought that it was
absolutely appalling.

19:37.690 --> 19:41.350
He has a very big personality,
and he had a television show,

19:41.348 --> 19:43.718
and what he did is he used
television,

19:43.720 --> 19:46.290
and quite frankly humiliation
tactics,

19:46.288 --> 19:48.718
to really embarrass the
government and persuade them to

19:48.720 --> 19:50.610
increase the funding for school
lunches.

19:50.608 --> 19:54.378
He is really credited with
providing the political will to

19:54.376 --> 19:58.406
increase the amount of funding
that schools got in Britain.

19:58.410 --> 20:02.060
Someone here in the United
States who's been a real hero is

20:02.064 --> 20:03.014
Alice Waters.

20:03.009 --> 20:06.709
She is the owner and chef of
Chez Panisse in Berkeley,

20:06.711 --> 20:08.991
California;
she is also the mother of a

20:08.988 --> 20:10.658
Yale--former Yale undergraduate.

20:10.660 --> 20:14.380
She created something called
The Edible Schoolyard,

20:14.380 --> 20:16.520
which is at a middle school in
Oakland,

20:16.519 --> 20:19.889
California where they created a
garden on the grounds of the

20:19.887 --> 20:23.537
school and they've done a really
remarkable job incorporating the

20:23.542 --> 20:27.202
gardening and the food that they
grow in the garden into not just

20:27.196 --> 20:29.706
the cafeteria but also the
curriculum.

20:29.710 --> 20:32.560
It's really a model program of
how to have a garden in the

20:32.558 --> 20:35.308
school and to make it part of
the child's experience.

20:35.308 --> 20:38.458
Right now, there is research
going on to try to assess what

20:38.463 --> 20:41.353
the effectiveness has been of
that program in terms of

20:41.346 --> 20:44.226
changing children's overall
nutrition and health.

20:44.230 --> 20:49.140
Then linked to that program is
a woman named Ann Cooper who was

20:49.141 --> 20:52.391
originally a gourmet chef from
Vermont.

20:52.390 --> 20:56.290
She then went to a place called
The Ross School in New York and

20:56.294 --> 20:58.754
completely revamped their
cafeteria,

20:58.750 --> 21:01.800
and then was recruited to go to
Berkeley,

21:01.798 --> 21:04.998
the school district where Alice
Waters is involved,

21:05.000 --> 21:08.080
and take over as the Food
Service Director of The Berkeley

21:08.076 --> 21:10.776
Unified School District
and--which is a huge school

21:10.778 --> 21:13.568
district--and to prove,
and her sort of personal

21:13.568 --> 21:16.128
mission is to prove that you can
have healthy,

21:16.130 --> 21:18.000
affordable food that children
will eat.

21:18.000 --> 21:20.300
She's another just really
charismatic,

21:20.298 --> 21:24.298
high energy person who has
taken this on and done what many

21:24.296 --> 21:27.706
thought was really impossible,
which was to change the

21:27.709 --> 21:30.779
sourcing of where the food is
coming from in school lunches,

21:30.778 --> 21:33.728
making it as healthy as
possible, and showing that

21:33.728 --> 21:37.398
children will in fact eat that
food if it's served to them.

21:37.400 --> 21:40.910
Then on the political front,
another real hero is Senator

21:40.905 --> 21:44.845
Tom Harkin who is from Iowa and
he's been probably the strongest

21:44.851 --> 21:48.731
champion of children's nutrition
and has introduced a number of

21:48.733 --> 21:52.123
bills over the years to set
higher standards for school

21:52.115 --> 21:52.925
food.

21:52.930 --> 21:55.760
Most recently,
he was behind the introduction

21:55.756 --> 21:59.546
of a federal law that said that
every school district in the

21:59.545 --> 22:02.945
country needed to write a School
Wellness Policy.

22:02.950 --> 22:05.450
I'll talk a little bit more
about this later,

22:05.445 --> 22:08.615
but he's really been just sort
of a tireless advocate for

22:08.624 --> 22:10.104
improving school food.

22:10.098 --> 22:13.128
I should also mention The
Clinton Foundation has been

22:13.133 --> 22:16.523
involved in this issue through
The Alliance for a Healthier

22:16.516 --> 22:19.176
Generation,
and they've done quite a bit of

22:19.182 --> 22:22.542
work with The American Heart
Association and the beverage and

22:22.535 --> 22:25.375
snack food industries and to
help the industries set

22:25.384 --> 22:28.744
voluntary guidelines that they
have agreed to follow in terms

22:28.738 --> 22:31.698
of the types of foods they'll
sell in schools.

22:31.700 --> 22:34.810
It's a little bit controversial
because those guidelines are not

22:34.808 --> 22:37.768
as strong as a lot of public
health advocates would like,

22:37.769 --> 22:40.649
but at the same time the
philosophy there is that it's

22:40.650 --> 22:44.130
better to work with the industry
and get the industry to agree to

22:44.128 --> 22:45.378
make these changes.

22:45.380 --> 22:49.310
Another person is the former
governor of Arkansas,

22:49.307 --> 22:50.587
Mike Huckabee.

22:50.588 --> 22:54.438
He is another very charismatic
speaker, very passionate about

22:54.440 --> 22:57.650
this issue, and always talks
about his own personal

22:57.648 --> 22:59.958
experience of losing 100 pounds.

22:59.960 --> 23:02.580
He's really become a crusader
on this.

23:02.578 --> 23:06.458
While he was governor he,
I think, introduced the most

23:06.461 --> 23:11.151
comprehensive statewide changes
to public schools in Arkansas.

23:11.150 --> 23:14.420
This actually included a lot of
things in terms of changing the

23:14.415 --> 23:16.685
food they had;
they're changing the contracts

23:16.686 --> 23:19.616
with vending machines,
but the part that got the most

23:19.617 --> 23:22.417
press was this controversial BMI
report card,

23:22.420 --> 23:25.330
which is they had each child
get weighed and measured at

23:25.333 --> 23:27.243
school, they calculated their
BMI.

23:27.240 --> 23:31.600
Then a report was sent out to
the parents telling the parents

23:31.596 --> 23:35.176
what your child's BMI is,
where it falls in terms of

23:35.179 --> 23:38.259
being normal weight,
overweight, or obese and then

23:38.255 --> 23:41.655
some guidelines and ideas of
what kind of changes you can

23:41.664 --> 23:42.644
make at home.

23:42.640 --> 23:45.870
A lot of people felt that this
was really inappropriate for the

23:45.865 --> 23:48.755
school to get into this,
and I think the media was

23:48.762 --> 23:51.812
really more upset about it then
the parents were,

23:51.808 --> 23:54.218
because they've been--in
Arkansas they've actually

23:54.217 --> 23:57.117
continued this program for I
guess they're probably in about

23:57.115 --> 23:58.585
the fourth year of it now.

23:58.588 --> 24:01.478
They've really found that
people have gotten used to it,

24:01.477 --> 24:03.417
that people are not upset about
it;

24:03.420 --> 24:06.050
you are allowed to opt out if
you don't want to get the

24:06.048 --> 24:06.728
information.

24:06.730 --> 24:10.610
What's been great about it is
they can now track BMI in the

24:10.608 --> 24:13.078
entire state,
and so they've been able to

24:13.078 --> 24:15.778
show that their efforts have
actually leveled off the

24:15.775 --> 24:18.985
increase in childhood obesity
that they were seeing before.

24:18.990 --> 24:22.460
Then right here in Connecticut
locally, I would say another

24:22.460 --> 24:25.570
important figure has been our
senate president Donald

24:25.571 --> 24:26.351
Williams.

24:26.348 --> 24:29.908
He has introduced legislation
both in 2005 and 2006 to

24:29.912 --> 24:33.412
strengthen the nutrition
standards we have in schools

24:33.405 --> 24:35.015
here in Connecticut.

24:35.019 --> 24:37.639
I'll tell you the story in more
detail in a bit,

24:37.640 --> 24:40.150
but this did as Kelly
mentioned, result in the

24:40.148 --> 24:43.158
strongest legislation in the
country on beverages.

24:43.160 --> 24:46.660
Then finally I think credit has
to go to The Robert Wood Johnson

24:46.661 --> 24:49.811
Foundation,
which as a private foundation

24:49.811 --> 24:54.721
has committed to spend $500
million dollars of obesity to,

24:54.720 --> 24:57.040
as they say,
reverse childhood obesity by

24:57.042 --> 24:57.452
2015.

24:57.450 --> 25:01.180
Their approach has been not at
all a medical model but much

25:01.183 --> 25:04.883
more of a public health model,
where their projects all are

25:04.880 --> 25:07.850
about improving access to
affordable healthy foods and

25:07.851 --> 25:09.591
increased physical activity.

25:09.588 --> 25:12.338
They specifically are focusing
on schools and communities,

25:12.338 --> 25:15.428
so a lot of the research going
on looking at schools right now

25:15.433 --> 25:17.873
is being supported by The Robert
Wood Johnson.

25:17.868 --> 25:22.028
Now I'm going to talk about
sort of how you make changes on

25:22.027 --> 25:24.947
the local level,
and tell a little bit about how

25:24.953 --> 25:27.583
I got involved in all of this as
a parent advocate.

25:27.578 --> 25:30.938
These are my three kids Anna,
Molly, and Charlotte.

25:30.940 --> 25:32.580
Molly and Charlotte are
identical twins,

25:32.577 --> 25:34.297
Anna's three years older than
they are.

25:34.298 --> 25:38.298
Basically I was working at The
Yale Center for Eating Weight

25:38.300 --> 25:42.370
Disorders doing research in this
area in the fall of 2002.

25:42.368 --> 25:45.028
Kelly was in the middle of
writing Food Fight and my

25:45.029 --> 25:47.729
oldest daughter started first
grade at the public elementary

25:47.734 --> 25:48.244
school.

25:48.240 --> 25:52.330
What I learned right away was
that they sell snack everyday at

25:52.327 --> 25:54.747
lunch,
and snack they defined as ice

25:54.748 --> 25:55.768
cream,
potato chips,

25:55.767 --> 25:57.557
things like that they called
them all snack.

25:57.558 --> 26:00.428
My daughter of course came home
and wanted fifty cents every day

26:00.432 --> 26:02.882
to buy this snack,
and I was really troubled by

26:02.884 --> 26:06.094
this, because I really didn't
want her to be buying snack,

26:06.088 --> 26:08.148
but then I was worried about
upsetting her.

26:08.150 --> 26:11.280
We ended up negotiating and she
was allowed to buy snack on

26:11.276 --> 26:13.536
Fridays, but I was really
uncomfortable.

26:13.538 --> 26:15.288
I wanted to go to the school
but I thought,

26:15.290 --> 26:17.750
gosh she's only been at school
for a week, I should probably

26:17.750 --> 26:19.420
not go marching in there right
away.

26:19.420 --> 26:22.380
I just decided to pace myself
and I was going to wait and see

26:22.380 --> 26:23.170
what happened.

26:23.170 --> 26:26.070
Well then, by December I got a
notice that they were having a

26:26.065 --> 26:29.245
family event featuring a cookie
eating contest as a fundraiser,

26:29.250 --> 26:34.150
and I basically just decided
that that was the last straw,

26:34.150 --> 26:37.220
that I couldn't really sit
quietly while they were have

26:37.224 --> 26:38.654
cookie eating contests.

26:38.650 --> 26:40.580
Of course Anna wanted to be in
the cookie eating contest,

26:40.577 --> 26:41.677
I had to explain no you can't.

26:41.680 --> 26:44.320
So I called the principal and I
decided to get involved.

26:44.318 --> 26:47.628
Fortunately in the district
where I live,

26:47.630 --> 26:50.860
the principal of my daughter's
school was very interested in

26:50.864 --> 26:53.674
this issue and I think,
in fact, had probably just been

26:53.670 --> 26:56.300
waiting for a parent like me to
come along to support her in

26:56.298 --> 26:57.678
trying to make some changes.

26:57.680 --> 27:01.010
What I learned is that the food
service is self-supporting,

27:01.012 --> 27:03.602
and this is really true across
the country.

27:03.598 --> 27:06.748
Part of what happened with the
competitive foods was this

27:06.748 --> 27:10.228
vicious cycle where they weren't
making a lot of money from the

27:10.233 --> 27:12.623
lunch sales,
so they started selling the

27:12.617 --> 27:14.627
competitive foods to make more
money.

27:14.630 --> 27:17.050
The more they did that the
lower down their lunch sales

27:17.051 --> 27:19.741
went because kids came in and
spent their money on the snacks

27:19.742 --> 27:22.432
instead of the lunch,
and they really got themselves

27:22.434 --> 27:25.134
into a position where the
majority of their income was

27:25.131 --> 27:27.981
coming from the snacks and not
from the actual lunch.

27:27.980 --> 27:30.760
That was problem number one.

27:30.759 --> 27:33.679
Number two, I learned that most
of the teachers actually didn't

27:33.684 --> 27:36.524
want to have all the birthday
parties and things like that in

27:36.516 --> 27:39.626
the classroom and all the food
being brought in for holidays,

27:39.630 --> 27:41.810
but they were actually afraid
of the parents.

27:41.808 --> 27:43.528
When I heard that,
I was like oh no,

27:43.530 --> 27:45.890
I'm sure you should not be
afraid of the parents,

27:45.891 --> 27:48.941
because I'm sure that most
parents feel just the way I do.

27:48.940 --> 27:52.370
I set out to prove that in fact
they all felt the same way I

27:52.371 --> 27:52.721
did.

27:52.720 --> 27:54.630
I decided I would do a survey.

27:54.630 --> 27:57.890
The first thing I did was an
online survey in our school

27:57.891 --> 28:01.051
district of all the parents,
where I asked lots of questions

28:01.045 --> 28:02.865
about how you felt about the
school food,

28:02.868 --> 28:05.018
how you felt about child's
nutrition,

28:05.019 --> 28:06.689
were you worried about your own
child, things like that.

28:06.690 --> 28:10.760
What I found was that 92% of
them said they did not want food

28:10.762 --> 28:13.482
offered as a reward in the
classroom,

28:13.480 --> 28:17.660
and then about two-thirds felt
that their child's diet wasn't

28:17.660 --> 28:22.080
as nutritious as it should be,
and 62% said their child eats

28:22.077 --> 28:23.317
too many sweets.

28:23.318 --> 28:25.848
I was gathering this
information so that I could make

28:25.852 --> 28:28.822
the argument that most of the
parents in my town actually were

28:28.821 --> 28:30.771
concerned about their child's
diet,

28:30.769 --> 28:33.329
did think that their child was
eating too much junk,

28:33.328 --> 28:35.928
and would like to see some of
these policy changes.

28:35.930 --> 28:40.650
I got some comments that I was
able to then take back to The

28:40.650 --> 28:44.090
Board of Education saying,
people saying things like I

28:44.085 --> 28:46.435
prefer to see only healthy foods
in the public schools,

28:46.440 --> 28:48.690
the kids are exposed to lots of
junk and calories,

28:48.690 --> 28:50.710
please take the junk out of the
schools,

28:50.710 --> 28:52.430
this is the most important
thing you can do for our

28:52.431 --> 28:52.811
children.

28:52.808 --> 28:56.138
So I was pretty sure that this
was going to be just fine.

28:56.140 --> 29:00.040
The second thing that I did in
working with the committee in my

29:00.041 --> 29:03.441
district is we did a nutrition
survey of all the fourth

29:03.441 --> 29:05.541
graders,
because this way I felt like I

29:05.541 --> 29:08.111
could show that the students
really weren't eating as well as

29:08.107 --> 29:09.217
we would like them too.

29:09.220 --> 29:11.150
We found a few things.

29:11.150 --> 29:13.990
The good news was we found that
actually the children were

29:13.990 --> 29:16.830
drinking the right amount of
milk so it did seem that that

29:16.833 --> 29:19.633
was not a problem;
these are fourth graders.

29:19.630 --> 29:22.590
Although we found that the
children were eating about half

29:22.594 --> 29:25.614
as many servings of fruits and
vegetables as they need,

29:25.608 --> 29:27.848
and they were eating nearly
three times the number of

29:27.846 --> 29:29.256
cookies,
ice cream, candies,

29:29.255 --> 29:30.875
fries, and chips as
recommended.

29:30.880 --> 29:32.680
I specifically looked at
cookies, ice cream,

29:32.678 --> 29:34.388
candy, fries,
and chips because those were

29:34.393 --> 29:36.613
the things that were being sold
in the cafeteria.

29:36.608 --> 29:39.458
With that information,
the committee met with the

29:39.461 --> 29:43.031
superintendent who suggested
that we sort of pick our battles

29:43.026 --> 29:45.696
and we start with the youngest
children,

29:45.700 --> 29:48.420
so we decided to focus on the
elementary schools in the

29:48.423 --> 29:49.033
beginning.

29:49.029 --> 29:52.459
The Food Service Director
agreed to take out all snacks,

29:52.462 --> 29:53.902
which is pretty huge.

29:53.900 --> 29:57.390
No snacks whatsoever--so just
the school lunch and then

29:57.392 --> 29:59.722
introduce some new lunch
options,

29:59.720 --> 30:01.990
things like wraps,
soups, and salads so that there

30:01.991 --> 30:03.571
were more healthy options there.

30:03.568 --> 30:06.758
Then the principals were still
scared of the parents with the

30:06.758 --> 30:10.158
snack foods being brought in for
birthday parties and things like

30:10.157 --> 30:11.967
that,
so rather than saying parents

30:11.967 --> 30:14.517
were not allowed to do it,
they sort of politely asked

30:14.520 --> 30:17.360
parents to please bring in
healthy snacks for birthdays,

30:17.358 --> 30:19.428
and so they would see how that
would go.

30:19.430 --> 30:22.500
Well, here's my advice to
anyone who ever tries to do

30:22.496 --> 30:25.206
this: is be prepared for
negative responses.

30:25.210 --> 30:28.350
Because on the one hand most
parents were very happy to see

30:28.346 --> 30:30.506
the food service change its
behavior,

30:30.509 --> 30:32.169
but what I learned was the
teachers were right:

30:32.171 --> 30:34.231
that once parents were asked to
change their own behavior,

30:34.230 --> 30:35.350
they felt very differently.

30:35.348 --> 30:39.308
First, I was called the
'cupcake police' and someone

30:39.305 --> 30:41.085
sent me this cartoon.

30:41.088 --> 30:45.248
Then I started getting emails
with different complaints,

30:45.251 --> 30:48.961
so I have a few quotes of some
of my favorites.

30:48.960 --> 30:52.020
One is, 'there are so many
rules and life seems like less

30:52.015 --> 30:54.405
fun nowadays for kids,
even in the Bible they

30:54.414 --> 30:55.784
celebrate with food.'

30:55.779 --> 30:59.699
Then there was 'This is America
where we continue to fight and

30:59.698 --> 31:02.138
die for the basic rights of
freedom.

31:02.140 --> 31:05.050
If parents and students choose
to drink whole milk and eat ice

31:05.046 --> 31:06.996
cream, they retain the right to
do so.'

31:07.000 --> 31:10.180
This was really interesting
because it was really showing

31:10.182 --> 31:12.402
that this wasn't so much about
food,

31:12.400 --> 31:16.860
this was really about this is
America, and we have rights in

31:16.855 --> 31:17.985
this country.

31:17.990 --> 31:21.100
Then I got the 'Come on
birthdays are only once a year.'

31:21.098 --> 31:23.758
I started thinking,
okay how can I respond to

31:23.756 --> 31:24.236
these?

31:24.240 --> 31:27.620
The first thing I did is I
started going around to all the

31:27.623 --> 31:31.243
different parent organizations
and doing presentations for the

31:31.243 --> 31:34.453
PTOs and try to explain the
rationale behind this.

31:34.450 --> 31:37.690
I did come up with this slide
to address the only once a year,

31:37.690 --> 31:40.870
because what I was realizing is
that parents think of their own

31:40.869 --> 31:43.949
child's birthday but they don't
necessarily think about every

31:43.946 --> 31:44.816
else's child.

31:44.818 --> 31:48.528
I made this slide to show all
the things that happen only once

31:48.531 --> 31:49.081
a year.

31:49.078 --> 31:51.198
Then I added in all the
birthday parties,

31:51.195 --> 31:53.255
and then I added in all the
cupcakes.

31:53.259 --> 31:56.989
What it really showed is that
in the life of these elementary

31:56.993 --> 32:01.043
school kids they are actually
exposed to a lot of these foods,

32:01.038 --> 32:03.208
and even though taken
individually it seems like they

32:03.211 --> 32:05.441
don't happen that often,
that put together,

32:05.438 --> 32:08.978
there are a lot of events where
kids are fed these foods.

32:08.980 --> 32:13.780
Then came the really hard part,
which was having to walk the

32:13.779 --> 32:14.349
walk.

32:14.348 --> 32:16.638
After making a big fuss,
I mean everyone in the whole

32:16.637 --> 32:19.147
town knew who I was because I
made such a fuss about these

32:19.146 --> 32:21.296
parties,
my daughter's birthday is in

32:21.295 --> 32:24.555
July, so at the end of the
spring semester they say all the

32:24.557 --> 32:28.097
summer birthdays can come in and
have a party to celebrate their

32:28.102 --> 32:28.892
birthday.

32:28.890 --> 32:32.520
Of course my daughter wants to
bring in cupcakes.I was put in

32:32.520 --> 32:36.090
this very difficult position
where I had to say to my little

32:36.092 --> 32:39.062
six going on seven year old,
I'm sorry honey,

32:39.059 --> 32:42.029
but mommy can't be seen
bringing cupcakes into the

32:42.032 --> 32:42.642
school.

32:42.640 --> 32:45.170
We need to come up with a new
solution.

32:45.170 --> 32:49.010
This was really tricky and I
tried to think of something and

32:49.007 --> 32:52.777
I came across--and now it's
actually fairly well known,

32:52.779 --> 32:55.699
but a while back this was one
of the early stages in--this is

32:55.696 --> 32:58.566
called Edible Arrangements--you
all have probably seen these

32:58.567 --> 32:59.537
products before.

32:59.538 --> 33:03.308
They make these fruit bouquets
where they cut up the fruit,

33:03.308 --> 33:05.058
it's very beautiful,
it looks like flowers,

33:05.058 --> 33:08.408
it easily costs ten times as
much as a package of cupcakes

33:08.405 --> 33:11.175
from Stop N' Shop,
but I had a point to make so

33:11.182 --> 33:12.342
money was no object.

33:12.338 --> 33:16.208
Anna and I we went online,
we checked out the website,

33:16.210 --> 33:18.470
we picked out the arrangement,
I drove to East Haven,

33:18.470 --> 33:21.480
I picked it up,
and I was all ready and having

33:21.477 --> 33:25.247
to talk about walking the walk,
I have to share with you that

33:25.247 --> 33:28.187
one of the most terrifying
moments in this whole thing was

33:28.189 --> 33:31.029
walking down the hall from the
parking lot to my child's

33:31.028 --> 33:33.438
classroom thinking,
if those kids don't like this

33:33.443 --> 33:34.843
fruit bouquet,
I am in big trouble.

33:34.838 --> 33:40.228
I just had to keep trusting
that it was going to be okay.

33:40.230 --> 33:42.320
I got there,
good news there is a very happy

33:42.321 --> 33:44.561
ending to this story:
that the kids saw it,

33:44.558 --> 33:46.858
they came running over,
they were completely excited,

33:46.858 --> 33:50.078
this little girl named Megan
who I will be clapping loud when

33:50.077 --> 33:52.707
she graduates someday,
was the first one to come over

33:52.710 --> 33:54.640
and say,
'wow you're so creative,

33:54.636 --> 33:55.756
that's so great!'

33:55.759 --> 33:59.069
And so the kids lined up and
they were completely fine,

33:59.071 --> 34:01.831
nobody said where are the
cupcakes, nobody was

34:01.833 --> 34:04.413
disappointed,
they truly did not care.

34:04.410 --> 34:06.710
They were a bunch of first
graders, there was a novel,

34:06.705 --> 34:09.125
sort of interesting thing
coming in, they were allowed to

34:09.132 --> 34:09.612
eat it.

34:09.610 --> 34:11.690
I learned a really important
lesson,

34:11.690 --> 34:14.510
which is in a lot of this,
it's the parents who are so

34:14.510 --> 34:17.600
scared of disappointing the
children or having the children

34:17.599 --> 34:21.219
get upset with them,
that they really are afraid to

34:21.224 --> 34:22.454
try new things.

34:22.449 --> 34:26.219
That was, I think,
an important experience in all

34:26.222 --> 34:27.012
of this.

34:27.010 --> 34:30.350
Then another one of the things
that I heard was 'You're going

34:30.351 --> 34:33.861
to make things worse by taking
the snacks out of the school,

34:33.860 --> 34:37.260
because this is going to lead
to children binge eating on

34:37.262 --> 34:38.722
those snacks at home.'

34:38.719 --> 34:41.729
That's an empirical question
that we were able to answer.

34:41.730 --> 34:43.820
Fortunately,
because I sort of knew that

34:43.818 --> 34:46.818
these snacks were going to get
removed the next year,

34:46.820 --> 34:49.370
before the end of the school
year in 2004,

34:49.369 --> 34:52.509
I went in and I did an
assessment asking kids about the

34:52.507 --> 34:55.817
snacks they ate school and the
snacks they ate at home.

34:55.820 --> 34:59.390
I was able to show that,
as you can see,

34:59.389 --> 35:01.549
they're eating a lot of snacks
at home and they're eating a lot

35:01.548 --> 35:04.358
of snacks at school,
so the home is the ice cream,

35:04.358 --> 35:07.338
the school is the red part on
top of that.

35:07.340 --> 35:10.250
Then in the second year,
I redid the survey at the same

35:10.248 --> 35:12.058
time,
year two, and found that

35:12.059 --> 35:14.819
consumption at school had gone
down obviously,

35:14.820 --> 35:16.990
I mean it wasn't being sold
there anymore,

35:16.989 --> 35:19.449
but home consumption was
staying the same.

35:19.449 --> 35:22.009
Now what's interesting about
this is some people say well

35:22.014 --> 35:23.714
home consumption should have
gone,

35:23.710 --> 35:26.430
like somehow we should have
made children stop thinking

35:26.429 --> 35:27.889
about ice cream altogether.

35:27.889 --> 35:29.179
Well, that didn't happen.

35:29.179 --> 35:31.799
What's more important is home
consumption did not go up,

35:31.800 --> 35:34.240
so it wasn't as though the
children knew,

35:34.239 --> 35:37.099
somehow were aware that they
had been deprived of their ice

35:37.096 --> 35:39.456
cream at school and ate twice as
much at home.

35:39.460 --> 35:41.770
They ate the exact same amount
at home as they had eaten

35:41.768 --> 35:43.608
before, and we did this for
several products,

35:43.614 --> 35:45.214
and it was the exact same
finding.

35:45.210 --> 35:47.720
This is potato chips,
this is frozen desserts,

35:47.724 --> 35:49.964
this is cookies,
brownies, and donuts.

35:49.960 --> 35:52.940
We consistently saw that
children were not doing this

35:52.938 --> 35:56.088
compensatory behavior that
people were worried about.

35:56.090 --> 35:58.790
Interestingly,
we did see that some of the

35:58.791 --> 36:02.681
healthier snacks were increasing
in consumption at home,

36:02.679 --> 36:04.649
like granola bars,
low sugar cereals,

36:04.646 --> 36:05.626
and baked chips.

36:05.630 --> 36:09.430
It seemed like we were also
observing kind of a cultural

36:09.427 --> 36:13.427
shift in terms of what people
saw as appropriate snacks for

36:13.434 --> 36:14.474
their kids.

36:14.469 --> 36:18.279
Now, at the same time,
a lot of things were happening

36:18.280 --> 36:22.090
the state in terms of changing
the snack offerings in

36:22.090 --> 36:23.850
Connecticut schools.

36:23.849 --> 36:26.939
I had the opportunity to work
with The State Department of

36:26.936 --> 36:30.346
Education on a much larger study
where we looked at three middle

36:30.347 --> 36:33.157
schools across the state and
three sort of comparison

36:33.161 --> 36:35.871
schools, and essentially did the
same thing.

36:35.869 --> 36:39.079
Went in, did an assessment of
how the children were eating,

36:39.079 --> 36:41.889
the next year removed the
unhealthy snacks and beverages

36:41.889 --> 36:44.949
from the school and then at the
end of that year did a second

36:44.954 --> 36:47.974
assessment of the students to
see how they were eating.

36:47.969 --> 36:50.609
We replicated the finding from
The Guilford Study that snack

36:50.605 --> 36:53.275
consumption decreased at school
and it didn't change at home,

36:53.284 --> 36:54.674
it stayed exactly the same.

36:54.670 --> 36:58.060
We were also able to get to
another question had been raised

36:58.059 --> 37:01.099
which was that we were somehow
going to trigger eating

37:01.103 --> 37:03.233
disorders with this type of
work.

37:03.230 --> 37:06.470
That we were going to increase
student concerns,

37:06.472 --> 37:09.992
dieting behavior would
skyrocket, and there would be

37:09.992 --> 37:12.342
all of these negative effects.

37:12.340 --> 37:15.780
We were able to assess both
weight concerns and dieting

37:15.784 --> 37:19.614
behavior across both conditions
and found that it was exactly

37:19.610 --> 37:20.440
the same.

37:20.440 --> 37:23.510
That there certainly is weight
concern and there is dieting

37:23.509 --> 37:25.679
behavior among middle school
students,

37:25.679 --> 37:28.049
but there was no difference
between those in the school

37:28.054 --> 37:30.614
where we did the intervention
and those in the school where

37:30.606 --> 37:31.966
everything stayed the same.

37:31.969 --> 37:34.369
I think that that's really
important,

37:34.369 --> 37:36.359
because unfortunately in this
field,

37:36.360 --> 37:40.170
there has been a problem of
eating disorder professionals

37:40.170 --> 37:43.710
sometimes being opposed to
obesity prevention efforts

37:43.708 --> 37:47.928
because they feel by definition
it's going to encourage sort of

37:47.927 --> 37:52.417
unhealthy weight restriction and
food restriction behavior,

37:52.420 --> 37:55.070
but there really hasn't been
evidence of this.

37:55.070 --> 37:57.480
Not in our research and in
Arkansas they've also been

37:57.478 --> 37:58.218
tracking this.

37:58.219 --> 38:01.639
Even with those BMI report
cards they've seen no increase

38:01.637 --> 38:04.867
in the reporting of eating
disorder behavior or eating

38:04.873 --> 38:07.203
disorders,
so I think that's an important

38:07.199 --> 38:08.279
thing to keep in mind.

38:08.280 --> 38:12.750
Another source of criticism or
concern that we were hearing was

38:12.751 --> 38:15.351
from other food service
directors.

38:15.349 --> 38:17.739
Some of the food service
directors in the state were

38:17.737 --> 38:20.737
making changes but others said I
can't make these changes because

38:20.735 --> 38:22.135
we're going to lose money.

38:22.139 --> 38:26.869
We did do some research,
both with the Connecticut data

38:26.865 --> 38:30.005
and a colleague of mine,
Chris Wharton,

38:30.012 --> 38:33.312
reviewed the literature from
other places that had tried out

38:33.311 --> 38:36.611
these programs and found that
schools that make changes like

38:36.608 --> 38:40.018
this on average do not lose
money and this is a really,

38:40.018 --> 38:42.258
really important thing to be
able to document.

38:42.260 --> 38:45.370
Basically what happens is,
I kind of mentioned that

38:45.367 --> 38:48.907
vicious cycle before,
is that when you take out the

38:48.911 --> 38:51.791
unhealthy a la carte,
and put in things like baked

38:51.791 --> 38:53.951
chips,
or low fat frozen yogurt,

38:53.949 --> 38:56.759
and your a la carte sales do go
down,

38:56.760 --> 38:59.590
so definitely children are less
likely to buy the baked potato

38:59.594 --> 39:01.364
chips then the regular potato
chips.

39:01.360 --> 39:04.250
However, they're still hungry,
they have to eat something.

39:04.250 --> 39:06.550
What happens is most times,
it's as though the kids say of

39:06.545 --> 39:08.995
fine I'll just buy the school
lunch since there's nothing good

39:09.001 --> 39:11.541
over here with these snacks,
and so your lunch sales go up.

39:11.539 --> 39:15.169
What we know from the previous
research that kids who are

39:15.166 --> 39:18.076
eating the school lunch tend to
eat better.

39:18.079 --> 39:20.319
This is really a win,
win because the nutrition is

39:20.324 --> 39:22.244
going to improve,
the amount of federal

39:22.235 --> 39:25.175
reimbursement the school's going
to get from their higher level

39:25.177 --> 39:27.637
participation in the school
lunch program is going to

39:27.644 --> 39:30.074
improve,
and I think it's definitely a

39:30.068 --> 39:32.568
beneficial thing,
but it was a leap of faith for

39:32.572 --> 39:35.102
these early food service
directors to try it and find out

39:35.097 --> 39:36.717
that indeed that's what
happened.

39:36.719 --> 39:41.409
Getting back to Brian Wansink's
M&M study;

39:41.409 --> 39:45.699
so I was thinking about this
accessibility and the idea that

39:45.699 --> 39:48.899
very subtle changes in how close
you are,

39:48.900 --> 39:51.020
like physically close you are
to a food,

39:51.018 --> 39:53.878
will affect how likely you are
to eat it.

39:53.880 --> 39:57.460
I was visiting my daughter's
school and watching the kids go

39:57.461 --> 40:00.741
through the line and noticed
that as part of the school

40:00.742 --> 40:02.622
lunch,
as I mentioned there are these

40:02.615 --> 40:04.065
five components,
the fruit, the vegetable,

40:04.074 --> 40:05.194
the protein,
the grain, and the milk.

40:05.190 --> 40:08.540
However, in order for a food
service director to get

40:08.536 --> 40:12.606
reimbursed for an official--for
like selling an official school

40:12.606 --> 40:14.676
lunch,
students only have to take

40:14.679 --> 40:17.559
three of the five components,
and it's their choice which

40:17.563 --> 40:20.393
three they want to take,
so what I was seeing was that

40:20.393 --> 40:23.413
kids were taking the protein,
the grain, and the milk and

40:23.405 --> 40:26.235
they were leaving--some of them
were leaving their fruit and

40:26.239 --> 40:27.199
vegetable behind.

40:27.199 --> 40:29.559
I thought to myself,
well what would happen if

40:29.557 --> 40:32.647
instead of letting them decide
whether or not to take it?

40:32.650 --> 40:35.700
If the people working there
basically put it on their tray

40:35.704 --> 40:38.014
and or told them they needed to
take it,

40:38.010 --> 40:40.480
so that when they left--when
they walked out of the line and

40:40.476 --> 40:42.936
went to sit down there was a
piece of fruit sitting on their

40:42.943 --> 40:43.323
tray.

40:43.320 --> 40:46.210
I approached the committee with
this idea,

40:46.210 --> 40:49.350
one of the principal's was
willing to give it a try,

40:49.349 --> 40:52.739
so we randomly assigned two
elementary schools to the

40:52.744 --> 40:55.164
experimental and control
condition.

40:55.159 --> 40:57.809
In the control condition they
just left it the way it was,

40:57.809 --> 41:00.819
the kids could make a choice;
and in the experimental

41:00.820 --> 41:04.990
condition, we trained the food
service directors to say to the

41:04.989 --> 41:06.489
student,
or the people working there to

41:06.494 --> 41:07.664
say to the student,
would you like juice or fruit?

41:07.659 --> 41:12.459
Because both fruit and 100%
juice would count as a fruit

41:12.456 --> 41:13.326
serving.

41:13.329 --> 41:16.089
Basically, the implication of
that question is you're taking

41:16.092 --> 41:18.202
one or the other--which one
would you like?

41:18.199 --> 41:21.399
They did that,
and in the control schools what

41:21.400 --> 41:25.740
I have here is showing how many
kids took the juice and the--I

41:25.740 --> 41:30.660
mean the fruit and the juice,
and how many kids actually then

41:30.664 --> 41:33.014
ate the juice and the fruit.

41:33.010 --> 41:35.800
I had parent volunteers go in
and observe, and then we

41:35.798 --> 41:39.058
collected the trays at the end
so we could actually measure and

41:39.061 --> 41:40.431
see how much they ate.

41:40.429 --> 41:44.479
What you can see is about 65%
of the kids took either the

41:44.481 --> 41:47.881
juice or the fruit,
and 45% then ended up eating

41:47.882 --> 41:50.272
both the juice and the fruit.

41:50.268 --> 41:53.338
In the intervention school,
it was much,

41:53.340 --> 41:55.850
much higher so the kids really
responded just from this verbal

41:55.847 --> 41:57.717
prompt,
would you like the fruit or the

41:57.722 --> 42:00.122
juice,
kids took it with--close to

42:00.121 --> 42:04.311
100% actually taking it,
and then interestingly the same

42:04.307 --> 42:07.627
proportion of those kids ended
up eating it,

42:07.630 --> 42:09.930
so you ended up instead of 45%
of the kids eating the fruit

42:09.929 --> 42:11.199
serving, it was closer to 65%.

42:11.199 --> 42:17.459
What was really surprising and
contrary to what people were

42:17.460 --> 42:20.420
saying,
is that the children who chose

42:20.420 --> 42:23.240
their fruit,
who actually sort of their own

42:23.237 --> 42:26.707
volition picked it up,
were just as likely to eat it

42:26.710 --> 42:29.560
as the children who were served
the fruit.

42:29.559 --> 42:32.719
People had thought that if you
served it that you'd end up

42:32.715 --> 42:36.145
wasting a lot more because all
the kids who wouldn't have taken

42:36.148 --> 42:37.808
it anyway,
would throw it away,

42:37.811 --> 42:39.061
and that's not what we found.

42:39.059 --> 42:41.159
The proportion was the same,
70%.

42:41.159 --> 42:44.089
It's notable though,
that because so many more kids

42:44.085 --> 42:47.005
were taking it and the
proportion was the same,

42:47.010 --> 42:50.660
the percent that got thrown
away did result in sort of at

42:50.664 --> 42:53.214
the baseline,
more fruit getting through in a

42:53.208 --> 42:53.448
way.

42:53.449 --> 42:55.159
So it's bigger numbers to begin
with,

42:55.159 --> 42:58.249
but at the same time that I
think the important point is at

42:58.251 --> 43:01.181
the end of the day more kids
ended up eating it than not

43:01.182 --> 43:01.932
eating it.

43:01.929 --> 43:04.349
This was published last year,
and this study got a fair

43:04.349 --> 43:06.989
amount of attention and I think
is being replicated in other

43:06.992 --> 43:09.342
places,
because this idea that subtle

43:09.342 --> 43:12.782
intervention can actually
increase fruit consumption,

43:12.780 --> 43:16.240
as opposed to all the effort it
would take to do sort of

43:16.240 --> 43:19.580
nutrition education and
imploring children to eat more

43:19.577 --> 43:21.537
fruit,
just putting it on their tray

43:21.539 --> 43:23.729
may end up being the most
effective way to do it.

43:23.730 --> 43:27.680
Now, I'm just going to review
what's happened here in

43:27.679 --> 43:32.389
Connecticut in terms of school
food policy from 2005 to now.

43:32.389 --> 43:35.169
As I mentioned,
we have our hero,

43:35.172 --> 43:39.002
Connecticut Senate President
Don Williams.

43:39.000 --> 43:43.160
He had--let me back up--he had
introduced this bill in 2005

43:43.163 --> 43:47.473
that set very strong nutrition
standards and was going to cut

43:47.469 --> 43:51.439
out a lot of the snack foods,
all of the sugared soft drinks,

43:51.436 --> 43:53.696
and he got it through the House
and the Senate,

43:53.702 --> 43:54.642
it was approved.

43:54.639 --> 43:58.629
It went to the Governor's desk,
and then Jodi Rell in June of

43:58.632 --> 44:01.102
2005 vetoed it,
which I personally was

44:01.096 --> 44:03.356
devastated when this happened.

44:03.360 --> 44:06.550
One of the things she said was
that Connecticut has a proud

44:06.545 --> 44:08.135
tradition of local control.

44:08.139 --> 44:12.969
Those are sort of code words
for politically,

44:12.969 --> 44:16.629
really leaving things up to the
local individual,

44:16.630 --> 44:19.360
as opposed to the state or the
federal government,

44:19.360 --> 44:22.170
making these sweeping policy
decisions.

44:22.170 --> 44:26.630
She said that what she would
prefer is that instead of us

44:26.628 --> 44:30.118
having a state law,
the local district should write

44:30.121 --> 44:32.201
their own school wellness
policies,

44:32.199 --> 44:34.649
and this is at the same time as
the federal mandate was coming

44:34.646 --> 44:37.036
out to do this,
and that that would be the best

44:37.038 --> 44:38.598
way to handle the situation.

44:38.599 --> 44:41.619
During this time,
these were due actually

44:41.623 --> 44:46.013
September 2006 but the idea to
start writing these policies

44:46.007 --> 44:49.407
actually came out a couple years
earlier.

44:49.409 --> 44:53.159
Every district in the country,
and so obviously every district

44:53.157 --> 44:55.877
in our state,
was required to write a School

44:55.884 --> 44:59.204
Wellness Policy which had to
include certain components.

44:59.199 --> 45:01.459
First of all it had to be
created by a committee.

45:01.460 --> 45:04.080
It couldn't just be written by
the board of education or the

45:04.083 --> 45:06.283
superintendent;
it had to have a committee that

45:06.280 --> 45:08.560
included parents and the food
service director,

45:08.559 --> 45:10.359
and administrators,
and students,

45:10.358 --> 45:13.168
so it was supposed to be a
representative group.

45:13.170 --> 45:17.370
It needed to include goals for
nutrition education in the

45:17.373 --> 45:19.233
school;
it had to include nutrition

45:19.233 --> 45:21.603
standards for all the foods
being sold in the school.

45:21.599 --> 45:23.419
It had to have goals for
physical activity,

45:23.423 --> 45:25.903
and it had to have a plan for
measuring implementation.

45:25.900 --> 45:29.640
I really felt like the law
written in a way that really

45:29.641 --> 45:33.801
encouraged people to do a very
kind of thoughtful job putting

45:33.797 --> 45:35.597
together their policy.

45:35.599 --> 45:39.429
What it didn't have was any
actually requirements for the

45:39.429 --> 45:42.339
quality of the policy,
so they didn't set any

45:42.342 --> 45:44.622
standards, for example,
for nutrition,

45:44.621 --> 45:46.641
for what foods you could sell.

45:46.639 --> 45:50.029
They just said you need to set
some standards at your local

45:50.027 --> 45:51.077
school district.

45:51.079 --> 45:57.029
The concern that I had was that
these may not work similarly

45:57.032 --> 45:58.952
across the board.

45:58.949 --> 46:02.119
That there might be some school
districts that take this really

46:02.123 --> 46:05.143
seriously and write a really
fabulous policy and end up with

46:05.144 --> 46:07.454
a much improved school food
environment,

46:07.449 --> 46:09.959
and there might be some
districts that don't have the

46:09.961 --> 46:12.911
time or the resources,
or the interest to do more than

46:12.911 --> 46:16.341
the bare minimum and basically
just write a policy that really

46:16.340 --> 46:17.690
doesn't say anything.

46:17.690 --> 46:21.540
Then there would be increased
disparities that you'd have some

46:21.538 --> 46:24.898
districts with great policies,
and the district next door with

46:24.902 --> 46:26.722
terrible policies,
and you'd end up with this

46:26.715 --> 46:27.585
really big difference.

46:27.590 --> 46:31.560
My original hypothesis was that
I thought it was going to be the

46:31.563 --> 46:35.603
low-income districts that were
going to have the worst policy.

46:35.599 --> 46:37.469
I was sort imagining here in
Connecticut,

46:37.469 --> 46:40.389
we have parts of the states
that are very--parts of our

46:40.394 --> 46:43.704
state that are very wealthy and
I thought of them having these

46:43.699 --> 46:46.949
really great policies and then
other cities in our state that

46:46.949 --> 46:50.089
are really low economic areas
where I was worried that they

46:50.090 --> 46:53.450
just wouldn't have the ability
to focus on this as an issue and

46:53.449 --> 46:56.049
they would end up with worse
policies.

46:56.050 --> 46:59.760
We submitted a grant to The
Robert Wood Johnson Foundation

46:59.762 --> 47:02.632
to study this,
and were funded to do that.

47:02.630 --> 47:06.750
So what we did in 2005,2006,
this was the year before those

47:06.750 --> 47:10.170
policies went into effect,
we did a baseline assessment

47:10.168 --> 47:12.838
where we surveyed the food
service directors to find out

47:12.836 --> 47:15.746
what they were selling and we
surveyed the principals to find

47:15.748 --> 47:17.688
out what kind of policies they
had.

47:17.690 --> 47:20.690
Then the next year came along.

47:20.690 --> 47:24.210
The wellness policies were due
at the beginning of the 2006

47:24.210 --> 47:25.060
school year.

47:25.059 --> 47:29.549
We then did a follow up
assessment,

47:29.550 --> 47:32.010
so that first year that those
policies would have gone into

47:32.014 --> 47:33.794
effect,
we again did a food service

47:33.793 --> 47:35.803
director survey and a principal
survey.

47:35.800 --> 47:38.570
Then we collected all of the
policies from the entire state

47:38.568 --> 47:41.478
and there are 151 if you ever
need to know this--there are 151

47:41.480 --> 47:43.820
school districts in the state of
Connecticut.

47:43.820 --> 47:46.760
We collected all of those and
proceeded to try to evaluate

47:46.762 --> 47:48.572
them to see how strong they
were.

47:48.570 --> 47:53.300
Then we looked at what was
called the macro level variable,

47:53.300 --> 47:55.530
so the demographic variables of
the districts,

47:55.530 --> 47:58.470
to see if there was a way of
predicting who had a better

47:58.467 --> 47:59.747
versus a worse policy.

47:59.750 --> 48:02.830
As I said, my hypothesis was at
the poorer districts,

48:02.829 --> 48:05.829
the more urban districts were
going to end up with worse

48:05.833 --> 48:08.013
policies,
and I imagined that some of the

48:08.005 --> 48:10.445
wealthier districts would have
stronger policies.

48:10.449 --> 48:14.799
We ended up looking primarily
at variables like the population

48:14.802 --> 48:16.882
of the district,
how big it was,

48:16.878 --> 48:19.558
the percentage of kids in that
district with free reduced

48:19.559 --> 48:22.289
lunch--so that's sort of an
index for income--we looked at

48:22.288 --> 48:24.968
the racial and ethnic
composition of the district,

48:24.969 --> 48:28.299
and then thanks to that parent
comment that 'this is America

48:28.298 --> 48:30.978
land of the free' one,
I thought it would be really

48:30.976 --> 48:33.326
interesting to look at the
political landscape of the

48:33.331 --> 48:35.341
district,
to think about whether the

48:35.340 --> 48:38.240
proportion of Democrats to
Republicans actually has an

48:38.239 --> 48:41.519
effect at the local level,
in terms of that general belief

48:41.519 --> 48:44.379
that it's an appropriate or
inappropriate thing for the

48:44.376 --> 48:46.966
school district to be setting
strong policies.

48:46.969 --> 48:51.759
What we found at baseline was
contrary to another thing which

48:51.755 --> 48:55.255
I had thought:
there was no clear association

48:55.264 --> 48:58.354
at baseline,
so this is before the policies,

48:58.349 --> 49:00.859
between the macro level
variables and the food

49:00.862 --> 49:01.702
environment.

49:01.699 --> 49:03.719
In other words,
in Connecticut the food

49:03.715 --> 49:06.465
environment was just as bad in
Greenwich as it was in

49:06.474 --> 49:07.274
Bridgeport.

49:07.268 --> 49:10.588
It was basically bad
everywhere, and so that was sort

49:10.592 --> 49:13.662
of an interesting first thing
that we learned.

49:13.659 --> 49:16.799
We also learned that
three-quarters of the districts

49:16.798 --> 49:20.118
didn't even have a policy,
and very few had things like

49:20.121 --> 49:22.401
guidelines for classroom
parties.

49:22.400 --> 49:25.020
It was only 6%,
very few prohibited food as

49:25.021 --> 49:28.831
reward--that was only 13%--and
the majority 85% said that they

49:28.831 --> 49:31.081
currently sell unhealthy snacks.

49:31.079 --> 49:33.729
That was kind of the picture
going into this.

49:33.730 --> 49:36.510
Then, as I said,
we collected the policies and

49:36.510 --> 49:38.240
we proceeded to code them.

49:38.239 --> 49:42.359
We came up with this sort of
complicated coding system where

49:42.356 --> 49:46.676
we had these seven domains where
we wanted to assess how strong

49:46.684 --> 49:48.294
of a policy it was.

49:48.289 --> 49:52.439
These were nutrition education,
standards for the school lunch

49:52.440 --> 49:54.660
program,
standards for the competitive

49:54.655 --> 49:56.195
foods,
physical education,

49:56.195 --> 49:58.515
physical activity,
a category we called

49:58.518 --> 50:01.728
communication and promotion,
so that had to do with efforts

50:01.728 --> 50:04.718
to engage the parents and to
make sure that all the messages

50:04.715 --> 50:07.395
in the school were consistent
with each other and then

50:07.398 --> 50:09.978
evaluation like what type of
plans did they have for

50:09.980 --> 50:11.550
evaluating their policy.

50:11.550 --> 50:15.830
What we then found was that
those macro level variables did

50:15.833 --> 50:19.783
predict the policy quality,
but in exactly the opposite way

50:19.777 --> 50:22.887
that I had thought,
so I was completely wrong on

50:22.889 --> 50:23.719
this study.

50:23.719 --> 50:27.249
Basically the more dense
districts, so these were the big

50:27.248 --> 50:30.148
city districts,
tended to have better policies,

50:30.146 --> 50:31.026
not worse.

50:31.030 --> 50:34.540
The more free and reduce lunch,
the higher those levels were in

50:34.541 --> 50:36.921
the district,
again the better the policies

50:36.920 --> 50:37.430
were.

50:37.429 --> 50:39.969
Then my political landscape
variable,

50:39.969 --> 50:43.489
amazingly, came out to be
significant where the proportion

50:43.492 --> 50:47.142
of democrats to republicans
predicted a stronger policy,

50:47.139 --> 50:49.209
so in other words,
the more democrats,

50:49.210 --> 50:52.430
the stronger the local school
wellness policy was.

50:52.429 --> 50:56.269
Now one question was there's a
relationship between the

50:56.271 --> 51:00.761
political sort of landscape and
the income sort of socioeconomic

51:00.755 --> 51:03.175
status,
so I did control for that in my

51:03.184 --> 51:06.184
analysis and found still that
that political landscape was a

51:06.179 --> 51:07.449
significant predictor.

51:07.449 --> 51:11.809
In the meantime we're been
doing our study,

51:11.809 --> 51:13.759
we've been funded to do this
pre-post thing,

51:13.760 --> 51:17.410
and then Senator Williams
introduces this new bill that I

51:17.414 --> 51:20.444
mentioned before,
where after the one that got

51:20.438 --> 51:23.348
vetoed by Jodi Rell,
he separated the nutrition and

51:23.351 --> 51:25.541
the physical activity parts of
the bill,

51:25.539 --> 51:28.419
he set the super strong
beverage standards,

51:28.420 --> 51:32.270
and then they created an
innovative program where they

51:32.268 --> 51:36.698
provided a financial incentive
for districts to follow certain

51:36.701 --> 51:39.971
food nutrition standards for
their foods.

51:39.969 --> 51:43.339
It's a little bit complicated,
but instead of requiring all

51:43.340 --> 51:46.190
the districts to only sell
snacks that met certain

51:46.188 --> 51:48.528
guidelines,
they basically told districts,

51:48.527 --> 51:51.247
you can choose to participate
or not to participate in this

51:51.246 --> 51:53.026
program,
but if you choose to

51:53.032 --> 51:56.462
participate we will pay you
three times as much money for

51:56.458 --> 52:00.128
our reimbursement for your
program as we typically would.

52:00.130 --> 52:03.800
So it was a pretty nice sort of
incentive for them.

52:03.800 --> 52:07.050
Then just from a strategic
perspective,

52:07.050 --> 52:10.190
I think Senator Williams having
gotten his bill vetoed the year

52:10.193 --> 52:12.373
before,
did a lot of things up front

52:12.367 --> 52:13.317
with this bill.

52:13.320 --> 52:16.170
He secured a promise from
Governor Rell that she would

52:16.168 --> 52:18.438
sign it,
he got a lot of support from

52:18.440 --> 52:20.410
the PTA,
CABE is the Connecticut

52:20.407 --> 52:22.607
Association of Boards of
Education,

52:22.610 --> 52:25.450
and the superintendents group,
so he was able to really get a

52:25.451 --> 52:26.921
lot of support on the ground.

52:26.920 --> 52:29.160
What was nice,
as Kelly mentioned a lot of our

52:29.155 --> 52:32.235
research that we've been doing
with The Department of Education

52:32.237 --> 52:34.917
was really helpful to kind of
reassure the food service

52:34.922 --> 52:37.412
directors that they would be
able to continue to be

52:37.407 --> 52:40.977
financially solvent,
and that the students would buy

52:40.976 --> 52:41.866
the lunches.

52:41.869 --> 52:44.819
The law changed in July.

52:44.820 --> 52:48.590
The vending machines were
emptied out and filled with only

52:48.588 --> 52:49.778
juice and water.

52:49.780 --> 52:52.210
This was all great news from
Connecticut,

52:52.210 --> 52:54.450
but in the meantime,
I was still doing my study,

52:54.449 --> 52:57.839
so it really messed up my
study, because part of my study

52:57.836 --> 53:01.276
was to see if these policies
were going to actually change

53:01.284 --> 53:04.884
what foods were available;
how many districts were going,

53:04.880 --> 53:07.380
for example,
take out soda as part of their

53:07.376 --> 53:07.966
policy.

53:07.969 --> 53:10.619
Well, I was never able to look
at that because they all had to

53:10.615 --> 53:11.175
do take it.

53:11.179 --> 53:15.159
I was still glad that the law
passed, but it did mean that my

53:15.155 --> 53:17.735
outcome variables had to be
adjusted.

53:17.739 --> 53:21.579
As I said, there was this
healthy food certification

53:21.583 --> 53:25.963
program, where the districts
could agree to participate and

53:25.956 --> 53:27.386
get this money.

53:27.389 --> 53:31.609
Instead of looking just at what
was being sold in the district,

53:31.610 --> 53:34.130
I was able to look specifically
at the districts that chose to

53:34.126 --> 53:36.186
sign up for this program,
and those that didn't.

53:36.190 --> 53:40.990
Luckily from a research
perspective,

53:40.989 --> 53:43.239
exactly half of the districts
signed up in year one for the

53:43.242 --> 53:45.092
program,
and at baseline or at--in

53:45.092 --> 53:48.562
looking at the ones that signed
up versus the ones that didn't

53:48.563 --> 53:51.293
there was no significant
difference on any of the

53:51.293 --> 53:52.663
demographic groups.

53:52.659 --> 53:54.899
So it wasn't as though it was
only the wealthy districts that

53:54.900 --> 53:56.800
signed up or only the poor
districts that signed up,

53:56.804 --> 53:57.704
it was really a mix.

53:57.699 --> 54:00.849
What I was able to do--and let
me just walk you through

54:00.849 --> 54:04.119
this--is I was able to look at
the year before the school

54:04.115 --> 54:06.445
wellness policies went into
effect,

54:06.449 --> 54:10.619
how many unhealthy a la carte
snacks were being sold,

54:10.619 --> 54:14.319
this one's for elementary
schools, and before and then

54:14.320 --> 54:14.880
after.

54:14.880 --> 54:18.180
I was able to split up the
districts that were just using

54:18.177 --> 54:21.177
their own personal local school
wellness policy,

54:21.179 --> 54:24.439
so that's the local standards
yellow line and compare them to

54:24.442 --> 54:27.762
the districts that chose to sign
up for the healthy snack,

54:27.760 --> 54:30.050
or the healthy food
certification and that were

54:30.050 --> 54:32.740
actually using the state's
standards, so that's the red

54:32.740 --> 54:33.190
line.

54:33.190 --> 54:36.380
This is a significant
interaction and what it shows is

54:36.376 --> 54:40.096
essentially that local control
are sort of leaving it up to the

54:40.103 --> 54:43.173
district meant there would be
some improvement.

54:43.170 --> 54:46.390
I mean the line does go down,
so it wasn't as though the

54:46.389 --> 54:49.669
local policies did nothing,
but they definitely didn't do

54:49.666 --> 54:51.536
as much as the state policy.

54:51.539 --> 54:55.059
It's kind of a tricky message
to give when people ask,

54:55.056 --> 54:57.906
were school wellness policies
successful?

54:57.909 --> 54:59.479
Well yes and no.

54:59.480 --> 55:01.780
They were successful in that
they did improve the picture,

55:01.780 --> 55:05.030
but they certainly didn't
improve the picture as much as a

55:05.032 --> 55:07.032
strong state policy was able
too.

55:07.030 --> 55:10.240
We found it's the same thing
for the middle schools and for

55:10.242 --> 55:13.512
the high schools and you can see
that in the middle and high

55:13.510 --> 55:16.160
schools,
the line did go down but it

55:16.161 --> 55:19.841
didn't go down all that much,
so there's still quite a bit of

55:19.838 --> 55:22.518
unhealthy food in the middle
schools and high schools that

55:22.521 --> 55:23.981
did not participate in this.

55:23.980 --> 55:28.160
Kind of to summarize this:
we did see a significant

55:28.155 --> 55:33.075
reduction in the sales of all
the unhealthy snack categories

55:33.081 --> 55:34.921
in all the levels.

55:34.920 --> 55:38.110
We also saw that the schools
that participated in this

55:38.106 --> 55:41.226
voluntary healthy food
certification had much greater

55:41.233 --> 55:43.703
reductions in their unhealthy
snacks.

55:43.699 --> 55:46.579
Finally, we found that the
strength of the policies,

55:46.581 --> 55:50.031
so this gets back to our coding
system, where we looked at how

55:50.027 --> 55:51.607
strong the language was.

55:51.610 --> 55:57.120
Did it say things like the
district shall do such and such,

55:57.119 --> 55:59.129
or did it say,
the district should do such and

55:59.132 --> 56:01.212
such,
so we really coded carefully to

56:01.211 --> 56:04.421
see how the policy was worded,
and whether it was kind of a

56:04.423 --> 56:07.193
suggestion or whether it was
really requiring change.

56:07.190 --> 56:10.310
What we found was that the
strength of the policy,

56:10.309 --> 56:13.959
so this was how many of their
statements were required did

56:13.958 --> 56:17.348
significantly predict the
reduction in unhealthy snack

56:17.349 --> 56:17.989
sales.

56:17.989 --> 56:21.539
The next thing we did is we put
together--and this is

56:21.538 --> 56:25.768
Guilford's--is we put together a
report card for every district

56:25.768 --> 56:29.998
in the state and this is sort of
the summary of their scores on

56:30.000 --> 56:32.730
each of those domains I
mentioned.

56:32.730 --> 56:35.550
We divided it into two
things--this is a little bit

56:35.552 --> 56:38.602
complicated--but if you focus on
the strength side,

56:38.599 --> 56:42.359
the strength side shows really
the proportion of statements

56:42.362 --> 56:46.132
that they had that were these
really strong statements that

56:46.126 --> 56:47.486
set requirements.

56:47.489 --> 56:50.589
The comprehensiveness gives
them credit for any statement.

56:50.590 --> 56:54.200
If they say something like we
recommend that the teachers not

56:54.204 --> 56:56.414
use food as reward,
they would kind of get a point

56:56.409 --> 56:58.229
in terms of comprehensiveness,
like they covered that domain.

56:58.230 --> 57:02.510
They would not get a point in
terms of strength.

57:02.510 --> 57:04.450
We put together these report
cards,

57:04.449 --> 57:06.999
these were sent out to each of
the districts and posted

57:07.001 --> 57:09.171
online--and then you can't
really see this very

57:09.173 --> 57:11.823
clearly--but we showed them
exactly how they scored.

57:11.820 --> 57:15.030
We went through every single
item--there are 96 of them--of

57:15.034 --> 57:18.304
the things we were looking for
in these policies and we gave

57:18.304 --> 57:21.414
them their exact score and
explained how we got--how they

57:21.409 --> 57:22.129
got it.

57:22.130 --> 57:25.710
The idea behind this was really
it's almost like an intervention

57:25.713 --> 57:28.843
in a way to see if giving this
feedback to the districts

57:28.842 --> 57:32.092
showing them how they scored
would in fact really motivate

57:32.085 --> 57:35.095
them to do a better job to
rewrite their policy and to

57:35.101 --> 57:36.241
resubmit it.

57:36.239 --> 57:39.469
Fortunately the Commissioner of
Education in Connecticut

57:39.467 --> 57:42.987
was--really backed this effort
and wrote a letter saying,

57:42.989 --> 57:45.919
here's your score we will be
asking for your policies again

57:45.918 --> 57:46.928
in a couple years.

57:46.929 --> 57:50.299
So there's really I think
motivation for the districts to

57:50.304 --> 57:51.634
take this seriously.

57:51.630 --> 57:54.930
One of the biggest criticisms
of the school wellness policies

57:54.934 --> 57:57.914
was that people felt like the
districts would write the

57:57.909 --> 57:59.659
policy,
they'd stick it on a shelf and

57:59.659 --> 58:00.929
nothing would ever really
change,

58:00.929 --> 58:03.279
so what we're really trying to
do here in Connecticut is make

58:03.284 --> 58:04.584
sure that that does not happen.

58:04.579 --> 58:08.439
This just shows all their
complicated feedback they got.

58:08.440 --> 58:13.560
As a state, this kind of gives
you an overview--on average as a

58:13.559 --> 58:17.359
state the state didn't do
particularly well.

58:17.360 --> 58:20.780
I mean we have a tough coding
system, so we really wanted to

58:20.784 --> 58:23.054
set the standard as high as
possible.

58:23.050 --> 58:26.440
As you can see,
a lot of these scores are in

58:26.442 --> 58:28.532
the 30s,
a couple in the 40s,

58:28.528 --> 58:32.128
interestingly the highest I
mean 49 for our coding system in

58:32.125 --> 58:35.655
the state was for the score food
and beverages and that was

58:35.659 --> 58:39.199
really because the ones that
signed up for the healthy food

58:39.195 --> 58:42.665
certification got pretty high
scores for doing so.

58:42.670 --> 58:46.340
I'm going to just wind down now
and review some of the key

58:46.338 --> 58:50.268
arguments that have come up in
all of this work trying to make

58:50.266 --> 58:54.186
changes in the schools,
and think about the type of

58:54.186 --> 58:58.496
research that we've been trying
to do to combat these.

58:58.500 --> 59:02.750
One of the key arguments that
you'll hear is these,

59:02.750 --> 59:05.770
what I call only statements:
students only eat five meals a

59:05.771 --> 59:08.301
week at school,
students drink only one can of

59:08.304 --> 59:10.754
soda a week from the school
vending machines.

59:10.750 --> 59:13.340
That second one was said about
four thousand times when

59:13.344 --> 59:16.424
Williams was trying to get the
soft drinks out of the schools.

59:16.420 --> 59:19.940
They kept saying it's only one
can of soda a week--as if that

59:19.943 --> 59:21.943
was a reason not to do anything.

59:21.940 --> 59:25.010
I think when you hear those
kinds of arguments you need to

59:25.009 --> 59:27.979
come back and say,
there are a lot of factors that

59:27.976 --> 59:32.356
contribute to childhood obesity,
just like the responsibility is

59:32.360 --> 59:36.110
really spread among all these
different things,

59:36.110 --> 59:39.530
but just because one factor is
not solely responsible doesn't

59:39.527 --> 59:42.087
mean that they aren't in part
responsible,

59:42.090 --> 59:44.800
and so it's really making the
argument that everybody needs to

59:44.797 --> 59:46.927
take responsibility instead of
always saying,

59:46.929 --> 59:49.719
it's not our product,
it's not our responsibility.

59:49.719 --> 59:53.489
Another thing that comes up a
lot is this idea of parents as

59:53.485 --> 59:56.775
the gatekeepers,
so the people who fight against

59:56.777 --> 59:59.257
making changes in schools will
say,

59:59.260 --> 1:00:03.520
parents can tell their children
not to buy unhealthful foods,

1:00:03.518 --> 1:00:06.038
or I got an email basically
saying,

1:00:06.039 --> 1:00:08.839
tell your first grader that
when somebody comes in to

1:00:08.844 --> 1:00:12.464
celebrate their birthday in the
classroom not to take a cupcake,

1:00:12.460 --> 1:00:15.300
they should just not take one,
they should say no thank you.

1:00:15.300 --> 1:00:17.600
Well, that's kind of ridiculous
obviously,

1:00:17.599 --> 1:00:20.609
but it's also just this
philosophy that it's really all

1:00:20.608 --> 1:00:23.838
up to the parents and that
parents should really be setting

1:00:23.840 --> 1:00:25.010
a better example.

1:00:25.010 --> 1:00:28.340
I think the argument back there
is to say, you're right,

1:00:28.336 --> 1:00:32.336
parents are responsible;
but the role of the school is

1:00:32.342 --> 1:00:35.612
to back parents up;
is to sort of do everything it

1:00:35.606 --> 1:00:38.566
can in order to provide an
environment where parents' job

1:00:38.565 --> 1:00:41.575
is easier, and where you're
really supporting parents;

1:00:41.579 --> 1:00:44.589
as opposed to an environment
where you're forcing parents to

1:00:44.588 --> 1:00:47.798
essentially teach their children
that they have to fight against

1:00:47.800 --> 1:00:49.330
the environment at school.

1:00:49.329 --> 1:00:51.789
That's just making parents'
jobs harder.

1:00:51.789 --> 1:00:55.559
There are also arguments about
education that we need more

1:00:55.556 --> 1:00:57.006
nutrition education.

1:00:57.010 --> 1:00:59.780
You hear that all the time:
we need to teach children to

1:00:59.775 --> 1:01:02.385
make good choices by providing a
range of choices.

1:01:02.389 --> 1:01:05.849
In terms of the education,
the argument I typically make

1:01:05.849 --> 1:01:09.749
is that there's no evidence that
this is being caused by a lack

1:01:09.750 --> 1:01:10.820
of education.

1:01:10.820 --> 1:01:13.450
That you don't see a rise in
childhood obesity over this

1:01:13.447 --> 1:01:16.317
short period of time because
suddenly people forgot that they

1:01:16.315 --> 1:01:18.415
should be eating fruits and
vegetables,

1:01:18.420 --> 1:01:22.600
or forgot that they shouldn't
be eating too much junk food.

1:01:22.599 --> 1:01:27.299
It's a pretty easy argument to
come back with that people know,

1:01:27.300 --> 1:01:30.980
even small children know what a
healthy--which is a healthier

1:01:30.978 --> 1:01:34.168
choice but that's not
the--that's not what is keeping

1:01:34.166 --> 1:01:37.716
them--not knowing isn't what's
keeping them from making the

1:01:37.722 --> 1:01:39.012
healthy choice.

1:01:39.010 --> 1:01:40.050
It's really about the
environment.

1:01:40.050 --> 1:01:42.810
Then this other argument,
which is really interesting,

1:01:42.807 --> 1:01:45.977
that you can't teach children
to make choices unless they have

1:01:45.981 --> 1:01:47.181
a range of choices.

1:01:47.179 --> 1:01:50.549
Kelly once said something that
really stands out in my head for

1:01:50.547 --> 1:01:53.077
responding to this one,
which is you don't teach

1:01:53.083 --> 1:01:55.943
children not to smoke by selling
cigarettes in school and then

1:01:55.943 --> 1:01:59.043
teaching them not to buy them;
that you just have to keep it

1:01:59.043 --> 1:02:00.653
out of the school altogether.

1:02:00.650 --> 1:02:03.300
So I think that that is a
pretty good response.

1:02:03.300 --> 1:02:07.440
Then people get kind of
personal and start calling you

1:02:07.440 --> 1:02:10.090
names and say,
you're big brother or that this

1:02:10.092 --> 1:02:12.622
is the nanny state,
and so that sort of gets back

1:02:12.621 --> 1:02:16.161
into this political ideology of
what is the role of the state in

1:02:16.164 --> 1:02:18.364
making policy about personal
things.

1:02:18.360 --> 1:02:21.380
Sort of going back to what
Rogan Kersch was talking about

1:02:21.382 --> 1:02:22.032
last week.

1:02:22.030 --> 1:02:25.070
Another big criticism was
unfunded mandate that

1:02:25.070 --> 1:02:28.710
the--whenever a state policy
goes into effect it doesn't

1:02:28.706 --> 1:02:31.346
provide more money for the
schools,

1:02:31.349 --> 1:02:33.119
the schools get angry and
that's understandable,

1:02:33.119 --> 1:02:35.719
so I think Connecticut provides
a nice model for that and that

1:02:35.715 --> 1:02:37.455
they did provide a financial
incentive.

1:02:37.460 --> 1:02:41.070
Finally, there's just sort of
the basic belief that schools

1:02:41.074 --> 1:02:44.884
should have local control and
that parents should have control

1:02:44.876 --> 1:02:47.616
over what's happening in their
district.

1:02:47.619 --> 1:02:51.659
The plan at The Rudd Center is
to continue to really refute

1:02:51.657 --> 1:02:54.787
each of these arguments as they
come along;

1:02:54.789 --> 1:02:57.999
to systematically do studies to
try to test out some of these

1:02:58.003 --> 1:03:01.223
ideas and show that the school
environment really does make a

1:03:01.215 --> 1:03:03.945
difference;
and then to find ways to frame

1:03:03.952 --> 1:03:08.012
these messages as we talk about
it in public or in testimony,

1:03:08.010 --> 1:03:11.140
or to the media so that they
can really appeal to all the

1:03:11.137 --> 1:03:12.197
political groups.

1:03:12.199 --> 1:03:15.389
I mean, one thing I've learned
is I'm really good at convincing

1:03:15.385 --> 1:03:18.565
people who think the same way I
do that this is a good idea.

1:03:18.570 --> 1:03:21.050
What I need to get better at,
is convincing people who don't

1:03:21.052 --> 1:03:23.852
think the same way I do,
so that we can really change

1:03:23.847 --> 1:03:26.867
the--sort of shift social
attitudes to support these

1:03:26.869 --> 1:03:27.579
policies.

1:03:27.579 --> 1:03:34.069
That's it, so I'm happy to
answer questions or comments.

1:03:34.070 --> 1:03:42.170


1:03:42.170 --> 1:04:19.070
Student:
>

1:04:19.070 --> 1:04:20.110
Marlene Schwartz: The
question is,

1:04:20.110 --> 1:04:22.590
it makes sense to do these
things sort of K-12,

1:04:22.590 --> 1:04:25.950
but at the university setting
people sometimes have this new

1:04:25.945 --> 1:04:28.045
freedom and can eat all they
want,

1:04:28.050 --> 1:04:30.700
and are there efforts to change
what's available in the

1:04:30.697 --> 1:04:32.067
university--is that right?

1:04:32.070 --> 1:04:35.590
I have not heard of
universities looking at this

1:04:35.592 --> 1:04:38.892
from specifically a nutrition
perspective.

1:04:38.889 --> 1:04:42.149
I mean certainly Yale has done
a lot in terms of sustainable

1:04:42.146 --> 1:04:44.346
food and things like that,
and education,

1:04:44.353 --> 1:04:45.903
which I think is linked.

1:04:45.900 --> 1:04:47.940
I mean, I think those will have
positive health impacts,

1:04:47.940 --> 1:04:52.450
but the only thing that I have
heard--which wasn't specifically

1:04:52.449 --> 1:04:56.079
for eating or weight concerns,
but I have a funny feeling

1:04:56.083 --> 1:04:58.963
might impact it anyway--is,
the University of Virginia was

1:04:58.961 --> 1:05:01.871
getting rid of their trays so
that students had to actually

1:05:01.867 --> 1:05:02.967
carry their plates.

1:05:02.969 --> 1:05:08.279
This is also sort of a Brian
Wansink inspired idea,

1:05:08.280 --> 1:05:10.840
that when you make it harder
for people to carry a lot of

1:05:10.844 --> 1:05:13.324
stuff they'll probably end up
carrying fewer things.

1:05:13.320 --> 1:05:15.780
In the end, I would not be
surprised if The University of

1:05:15.777 --> 1:05:18.147
Virginia students were eating
less because of that,

1:05:18.150 --> 1:05:19.790
but the reason for it was all
about the environment,

1:05:19.786 --> 1:05:20.586
it wasn't about weight.

1:05:20.590 --> 1:05:23.780
That's the only thing I've
heard of.

1:05:23.780 --> 1:05:32.080


1:05:32.079 --> 1:05:34.419
Prof: If anybody has
questions, you can come up and

1:05:34.423 --> 1:05:35.703
talk to Marlene individually.

1:05:35.699 --> 1:05:37.999
Let's thank her again for
coming here today.

1:05:38.000 --> 1:05:44.000