From the Allergic Living archives; this article was published in 2008 in the Canadian edition of the former print magazine.
THE PIZZA day. The monthly birthday cake. Classroom treats from the teacher for a job well done. Those holiday celebrations. The dad with the MBA using spreadsheet skills to organize the preschool snack schedule.
The amount of food the average child comes in contact with at the modern school is several times what his 30- or 40-something parent encountered as a pupil. Today’s staples include the pizza-at-school fundraisers, rich and fatty cafeteria food, and school vending machines brimming with oversized beverages and chocolate bars.
Add to the mix the modern child’s obsession with computers, the hours of instant and text messaging time, and results are a shocker: kids across the Canada and the United States are more overweight now than at any other time in history.
Between 1978 and 2004, government statistics show that the proportion of overweight Canadian kids aged 6 to 11 doubled to 26 per cent, while the rate of teenagers who were too heavy also doubled – to a whopping 29 per cent. The rate of obese teens tripled to 9 per cent. Due to weight issues, the Canadian government stated that, for the first time, this generation of children might not live as long as their parents.
In the United States, over the past three decades there has been a doubling of obesity rates for preschoolers and teens, and a tripling for the 6-to-11-year-old group.
“Kids are drinking more sugary drinks, and you have exercise being designed out of their lives,” says Dr. Brian McCrindle, a cardiologist at The Hospital for Sick Children in Toronto, professor of pediatrics and author of Get a Healthy Weight for Your Child. “Because of safety concerns, they don’t play outside, and you see a proliferation of sedentary pursuits, video and computer.”
As children have grown ever heavier, the concurrent trend, of course, is the skyrocketing of food allergy. A study from Mount Sinai’s School of Medicine in New York, published in 2004, confirmed what allergists knew anecdotally; the incidence of food allergy in the U.S. had doubled, and those statistics are mirrored in Canada. Six to 8 per cent of Canadian school children now have food allergies, which can cause dangerous, even life-threatening reactions. Provinces and states are considering and, in a few cases, passing anaphylaxis-readiness laws in the schools.
But as those bring restrictions on what is appropriate for the lunch box, simultaneously, the weight issue has grabbed the attention of educators and the media. The result: the pendulum is beginning to swing toward better nutrition in some schools. This means a new focus on fruits and vegetables, which happens to dovetail neatly with concerns about allergens in the classroom, since those foods are not the top allergenic sources, and they won’t lead to accidental exposures.
Classroom Food Celebrations
The Institute of Medicine, a scientific advisory group based in Washington, produced a report in April, 2007 calling for a dramatic new approach to food in the classroom: no food as rewards; no food for celebrations. Then it ranked foods into tiers. Tier 1 is acceptable: fruits, vegetables, real juice, low-fat dairy, and nothing with trans fat.
These are the only snack foods to be allowed for elementary school children and fundraising efforts, while higher-fat and sugary Tier 2 food could be available for after-school activity for teens. No snack, though, should be more than 200 calories.
The Institute of Medicine report also took aim at food sold to raise funds for schools, recommending it be curtailed. At the same time, a new bill that would amend the Child Nutrition Act to eliminate junk food from U.S. schools is gaining support in Congress.
Bill Jeffrey, national coordinator of the Canadian wing of the Center for Science in the Public Interest, wrote a response to the Institute of Medicine’s report, calling for Canada’s federal government to take serious leadership on school nutrition. “We don’t have a good snapshot of food in the schools nationally,” he says. “There needs to be a national approach to improving it.”
Indeed, there is a provincial patchwork approach to both food allergy and nutrition in the schools. “Things are changing with regard to improved nutrition,” says Dr. Peter Nieman, a Calgary pediatrician. “But they are changing too slowly.”
One province showing leadership after a wake-up call is Nova Scotia. A 2003 study found more than 40 per cent of kids in Grade 5 to be overweight or obese, with poor kids more likely to be overweight, so the province decided that change had to come.
Nutrition over Deep Fryers
In 2006, it began phasing in (over three years) its Food and Nutrition Policy for Nova Scotia Public Schools. The policy states boldly that food must be for nourishment rather than revenue generation. It bans sports drinks and deep fryers from cafeterias, eliminates super-sized portions, and ranks foods (and when they’re allowed to be eaten) according to nutritional content.
Peter McLaughlin, spokesperson for the Department of Education, says schools expressed the greatest concerns with strict guidelines in the area of fundraising (no more cookie dough). To clarify, a comprehensive guide was created. “We were helped by the warnings that this would be the first generation not to outlive their parents,” he says. At the same time, Nova Scotia is updating its anaphylaxis guidelines and undertaking more emergency training.
In Ontario, the food-in-the-class debates have been focused on compliance with Sabrina’s Law, the groundbreaking anaphylaxis legislation. But nutrition is also building as an issue.
In late 2004, the Ministry of Education released guidelines for school boards that targeted the sale of chips and chocolate bars in elementary school vending machines. School boards were advised to restrict snacks to those that are nutritious, including fruit cups and some types of granola bars, crackers and cookies. Lower-fat milk, water and 100 per cent fruit juice were recommended as beverages, and the guidelines are part of a broader health framework.
Meantime, British Columbia is working with its school boards with the goal of eliminating junk food in the vending machines and cafeterias, and has introduced a program called Healthy Schools.
But beyond provincial or statewide policies, changing the dynamic of food in the classroom also comes down to a single school’s own initiative. In the case of one Mississauga, Ontario school, the approach to reducing allergens in the junior kindergarten is steeped in nutritional advantage.
St. Basil Elementary School implemented a fruits and veggies-only snack regime for its junior kindergarten pupils two years ago. This came about following discussions with a parent whose child had had an anaphylactic reaction. To make the classroom safe for that pupil, his teacher suggested this nutritious (if more limiting) solution.
Clifford Read, the school’s principal, agreed. “This was as controversial as anything I’ve done in this school,” he recalls. “Parents were saying ‘what about cheese and crackers?’ They felt we were judging them. We really had to stick to our guns around fruits and vegetables,” he says. “We explained to them that we were looking for healthier snacks.”
St. Basil has gone even further with allergy protocols. In all grades, classroom birthday parties now don’t include food, but games. No food is allowed in the playgrounds, as it adds risk for food-allergic children and attracts bees (another anaphylaxis risk).
The fruits and vegetables message has spread to Ecole Saint-Clément in the Town of Mount Royal, on the island of Montreal. Dr. Valérie Marchand has two daughters enrolled there, both of whom have multiple food allergies. The school is trying to improve nutrition and protect those with food allergies. Every Tuesday and Thursday, students must bring fruit and vegetable snacks only.
“It’s not as easy as buying a quick snack at the store, but it’s healthier, and better for children with allergies,” says Marchand, a pediatric gastroenterologist at Montreal’s Ste-Justine Hospital, who often sees infants with failure to thrive, sometimes due to food allergies.
But while anaphylaxis awareness in the schools has grown considerably, the pace of change on its nutrition counterpart is slower. And there’s a good reason: schools today have embraced foods, many of them unhealthy, for fundraising and as classroom rewards. Changing that dependence is a big undertaking.
Consider the experience of Kari Gregory. She spent 10 years as an Alberta junior high and high school teacher and found food a common incentive in the classroom. “I don’t like the whole rewards thing; students need to do their best work because it teaches them to be accountable,” says Gregory, who left teaching to care for four daughters and now works as a personal trainer.
When she taught, she’d bring in a big bag of fruit. “Often kids would ask me for a fruit. One might be hungry or another forgot his lunch.” She knows teachers, even excellent ones, who still give out sugary treats. “I think teachers are lost about what to give as rewards. It’s cheaper to buy a tub of $3 jelly beans, than other more nutritious snacks.”
Fundraisers’ Sugary Treats
Then there are the fundraisers at her daughters’ school: pizza days, taco days, and subway sandwich days, all to raise funds for the parents’ advisory council. More fundraising is a fact of life in many public schools. In Calgary, Roman Catholic Bishop Fred Henry banned the high-earning casinos, so the Catholic schools in that city have turned now to food as one of several fundraising tools. This is still common.
Kate Caldwell is a teacher in Cobourg, Ontario. She has qualms about certain fundraising practices, but takes a different view on food in the classroom: “I see school celebrations as a teaching moment.” She works in the same school as her daughter, who is food allergic and asthmatic. In a supervised setting with the practice of washing hands well-established, Caldwell says that food-allergic children and their friends can learn how to manage food allergies.
Caldwell and her husband, also a teacher, share the concerns about junk food, though. “A local school is currently raising money for new playground equipment and the parent group has sold chocolates, milkshakes and suckers throughout the school year. I joked with my husband that by the time the money is raised, the children will all be overweight and really need the equipment.”
Caldwell believes there are higher expectations now than when she was a child for school trips, and playgrounds are more expensive to build because of enhanced safety standards.
Fundraising is ingrained as a means of providing for sports teams, music programs, field trips or sometimes even basic school costs, such as library books. Gregg Bereznick is a superintendent of education for the Waterloo Region District School Board in Ontario and has watched this evolve over 25 years in the school system.
“There is a growing interest in fundraising to enhance those extras in the elementary schools,” he says, and that often involves food products. But at the same time, schools are dealing with food allergies, diabetes and other health issues.
Food Situations are Complex
“For principals, the food landscape has never been more complex,” says Bereznick. He describes a duality – while there may be more food in the schools, there is also more focus on health. “I think the birthday cake in the classroom is a dying trend. I’m not saying it doesn’t happen, but the current group of parents is more interested in nutrition than ever before.”
In looking to the future, Anne Muñoz-Furlong, the founder and former CEO of the Food Allergy and Anaphylaxis Network [now FARE], sees a natural evolution between the recognition of kids’ nutritional needs and awareness of food allergies in school.
“From an educator’s perspective, having everyone avoid sweet snacks and desserts, which often contain allergens such as milk, eggs or peanuts, will make it easier to keep the children with food allergies safe. However, this goes beyond food allergies; the children with other diseases, such as diabetes, will benefit as well.”
As the food allergic are all too aware, telling other parents what they can and can’t pack in their children’s lunches can be fraught with controversy. But the beauty of the nutritional approach is that it is for the benefit of everyone’s children, with food allergic kids also reaping the benefits of lessened exposures.
As Muñoz-Furlong notes, “fruits and vegetables are a better food choice for everyone.”
Change in that direction may be slow and uneven, but given the alarming statistics on children’s weight and allergies, in North America more provinces and states may soon feel the pressure to get in step with Nova Scotia’s lead.
And one day, in the not-so distant future, perhaps a child will ask: “Mom, did you really used to eat cake – at school?”
Originally published in Allergic Living magazine.