Search Results

Findings from a newly published study in the Journal of the American Medical Association (JAMA) reportedly indicate that there has been “modest” improvement in the diets of American children over the 17-year period from 1999 to 2016. However, this study appears to contradict the CDC’s data that childhood obesity has climbed from 14% to 18.5% in that same period as well as the research indicating that the incidence of type 2 diabetes among children is on the rise. While these seemingly paradoxical data can technically all be true at the same time, color me skeptical that American kids’ diets are meaningfully—or even modestly—improving. To interpret for ourselves what the JAMA study really shows, let us scrutinize the scoring criteria, the study’s actual data, and the crafted narrative surrounding the findings. First, the scoring criteria. To estimate diet quality, the study uses the Healthy Eating Index (HEI) and the dietary standards put forth by the American Heart Association (AHA). Both the HEI and AHA surveys evaluate a combination of food groups and individual nutrients like saturated fat and sodium from self-reported dietary records. Perusing through the criteria, I spot a number of issues. For example, per both surveys, 100% fruit juice counts toward one’s daily servings of fruits without any limitation or cap despite the fact that juice and whole fruits do not have equal nutritional value. Given that these surveys are rooted in the USDA Dietary Guidelines (which are a product of industry lobbying), this criterion feels more political than evidence-based. Unsurprisingly, the other criteria are equally dubious. Case in point: Consumption of processed meat, a known carcinogen, is allowable up to half an ounce per day for full credit on the AHA survey. That’s equivalent to eating two and a half hot dogs or five strips of bacon per week; as a nutritionist I find this wildly excessive for an “ideal” intake. Contrast that with the target intake for legumes, nuts, and seeds at just four servings per week. I would argue for a minimum of at least one daily serving of these plant proteins. The surveys are flawed not only for what they include but also what they fail to include. Ultraprocessed foods, which make up more than 50% of the American diet, are not evaluated or scored. The surveys also fail to discriminate between 100% whole grains and partially whole-grain foods, which could lead to an overestimation of whole grain intake. On the HEI survey, seafood and plant proteins are categorized together—a mystifying decision by the survey architects; moreover, all “protein foods”—an outdated concept—are lumped together in another category that includes seafood and plant proteins again. Red meat, poultry, seafood, dairy, nuts, seeds, and legumes simply do not belong in one category! There are yet more issues with these surveys that, in my opinion, render them ineffective at capturing true diet healthfulness, but for the sake of brevity, let’s move on. Second, the data. The study reports an improvement in kids’ diet quality within the range of 11 to 27%. However, looking through the numbers, I believe the data show marginal progress in some areas and potential regression in others. Before we look at the data, it’s important to note the very large sample size of this study—31,420 kids in total. Due to this large sample size and the way statistical significance is calculated, minor changes in consumption will be deemed “significant” or “real” despite having little to no practical impact on health outcomes. Keep this in mind. The biggest reported dietary improvement is in the consumption of whole grains, which appears to have doubled from 1999 to 2016. However, the baseline intake was already extremely low at just half a serving per day, so a doubling in this context means kids are now getting just one serving of whole grains per day. The likely explanation for this increase is that the food companies who produce sugary breakfast cereals and other ultraprocessed grains products have increased their products’ whole grain content, yet these products remain extremely sugar-laden and refined. And, as noted earlier, it is unclear whether or not the survey differentiated between 100% whole grains and partially whole grains. Ultimately, “whole grain” labeling on these products is nothing more than a cynical marketing tactic that has little to no positive effect on kids’ health while kids are still consuming six times as many refined grains as whole grains. There’s a decent bit of bad news from these data as well. Consumption of vegetables has not increased. Red meat consumption appears to have declined, but poultry and processed meat consumption have more than taken its place. Moreover, the consumption of cheese (high in saturated fat) and eggs (which contain cholesterol and TMAO precursors) has increased considerably. Although added sugar intake has reportedly decreased, saturated fat, sodium, and cholesterol have all gone up in kids’ diets. This is where my interpretation of the data diverges most starkly from that of the study’s authors. They see the increased consumption of higher-fat dairy products and other “protein foods” like eggs as improvements despite the fact that the result is an increase in dietary cholesterol, sodium, and saturated fat intake. Personally, I find the positive outlook on these data rather antiquated. The study reports that the proportion of children consuming “poor” quality diets, defined as less than 40% adherence to the survey criteria, dropped significantly from 77% to 56%. I want to celebrate this change, but due to the many problems I’ve outlined above, I can’t help but be skeptical. From what I see, there have only been marginal improvements in fruit, whole grain, and plant protein, fiber, and added sugar intake while the consumption of animal protein, sodium, saturated fat, cholesterol, and processed meat—all of which are implicated in our crisis of diet-related disease—has gone up. Is this really the best we can do in 18 years of nutrition and public health advocacy? Finally, the crafted narrative. Saying kids’ diets improved by 27% is like saying a change from 2 to 3 is an increase of 50%. Mathematically, they’re both true, but focusing on the percentage devoid of context obscures the reality that we’ve barely made progress in our kids’ diets over the last two decades. If American children’s diets had truly improved as this study claims, could we realistically have seen incidence of obesity continue to rise since 1999? It is doubtful, and frankly, I believe these surveys are adept at measuring adherence to a set of industry-driven dietary guidelines. And better adherence appears ultimately to not per se lead to better health outcomes for our kids. This is perhaps why, despite the celebratory rhetoric surrounding the “progress” in our diet quality, a crisis of diet-related disease continues to rage on and worsen among this country’s youth. The lesson in all of this is that, if we want to be serious about meaningfully improving our kids’ diets, we need higher standards for how we measure diet quality—standards devoid of antiquated elements like “protein foods” and industry-mandated dairy requirements. We need to focus on practical significance as well as statistical significance, which in this case would manifest as a precipitous drop in rates of obesity, pre-diabetes, hypertension, and other diet-related diseases in kids. As a country, we must marshal our resources to ensure every child has access to a diet rich in plant foods and to reign in large predatory food corporations and lobbies. And, to those scientists who produce research, it is time to stop obscuring the facts and stop validating and enabling industry influence in the science- and policy-making processes. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org To request information about balancing your institution's menu and receive support (FREE!) one-on-one support from Maddy in doing so, please email Maddy directly or visit our Institutional Support page. From there, you can download a step-by-step guide and get started today! Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

From its origins in the “wet markets” of Wuhan, China, to the implications of poor diet on survival from infection, the novel coronavirus is a pathogen inextricably bound up with food and nutrition. By now, we’ve all heard that the best things we can do now to attenuate the spread of the virus include, as the CDC and other authorities have noted, practicing social distancing, washing our hands frequently, covering our coughs and sneezes, and staying home when we’re ill. If you’re a smoker, now is a better time than any to quit. This advice, while critical, doesn’t address a major underlying issue—that our already-dire state of public health leaves large swathes of the population, particularly older adults, far more vulnerable to developing severe symptoms that require hospitalization or result in death from COVID-19. For most of us, this isn’t a matter of if we’ll be infected, but when. While slowing transmission is key, we as individuals, communities, and a nation must confront this glaring vulnerability to improve survival immediately and in the long run. Medical professionals on the frontlines of the outbreak in China have reported that diet-related diseases, especially high blood pressure, may dramatically increase risk of dying from a coronavirus infection. This news could spell disaster for older Americans, nearly 80% of whom have more than one chronic illness such as diabetes and heart disease. More concerning, over 100 million American adults of all ages have high blood pressure. From a human biology perspective, it isn’t surprising that older adults are harder hit by this disease given the body’s natural decline in immune function with age, in part responsible for higher rates of chronic illness. However, we should not underestimate the role widespread diet-related disease will play in worsening mortality from COVID-19—nor should we downplay diet’s foundational role in both building up our immune defenses and combating their natural age-related decline. In one study involving nearly half a million participants, researchers found that individuals who consumed the most fruits and vegetables had roughly 30% lower mortality from respiratory illnesses in comparison to those who consumed the least. Incidentally, those eating the most produce also had 15% and 40% lower mortality from cardiovascular and digestive causes of death, respectively, further outlining the dietary link between chronic disease and poor immunity. Moreover, in a randomized controlled trial investigating the effects of fruit and vegetable consumption on immunity, elderly participants eating five servings of produce per day for 12 weeks produced more antibodies in response to a vaccine that protects against pneumonia and other “pneumococcal” diseases than participants consuming only one serving per day. This demonstrates that, in just the span of a couple months, older adults who switch to a more plant-rich diet can significantly improve their immune responses to infectious diseases. In the context of the COVID-19 pandemic, this could mean the difference between life and death. Beyond individual survival, it is critical that we as a population do our best to keep the rate of transmission as low as possible so as not to overwhelm resource-limited healthcare facilities. This is where broader access to and consumption of health-promoting foods becomes even more important. We know from research on the spread of influenza that higher rates of diet-related illness and lower rates of fruit and vegetable intake in a given community significantly increase hospitalization rates. Communities with higher rates of obesity, for example, are more likely to see their hospitals inundated during a flu outbreak. Thus, this is not just an issue of personal health, but also a matter of how policy shapes our food environments to either the benefit or detriment of public health. Sadly, our elected officials have fundamentally failed to address our worsening crisis of diet-related disease—a fact that will surely frustrate our efforts to overcome the outbreak. Meanwhile, our federal and state governments have continued to subsidize disease-promoting products as Americans grow ill from a diet deficient in foods fundamental to our health—fruits, vegetables, legumes, and whole grains. For too long, policymakers have neglected to reign in the Big Food industry, which peddles its ultraprocessed products in schools, hospitals, and corner stores and which knowingly misleads the public. Worse still, only the bare minimum has been done to address rampant poverty, homelessness, and hunger in this country. In short, we are artificially and needlessly sicker and more vulnerable thanks in large part to our government's failure to invest in public health—simply because it is not politically or financially expedient. Moving forward from the present ordeal, all levels of government must confront not just the immediate pandemic, but also the crisis that has been shortening and taking the lives of millions over several decades. The coronavirus has laid bare much of the incompetence and willful blindness public health advocates have been pushing back against. We are determined to show decision-makers that it doesn’t take an ideal world for a healthy, balanced diet to be convenient and accessible to all. In the meantime, during these overlapping crises of diet-related and infectious diseases, let us all do what we can to look out for one another and support those in our communities who are most vulnerable. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org To request information about balancing your institution's menu and receive support (FREE!) one-on-one support from Maddy in doing so, please email Maddy directly or visit our Institutional Support page. From there, you can download a step-by-step guide and get started today! Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

In anticipation of the USDA’s latest industry-backed political antics, many health advocates, school nutrition professionals, and concerned parents have been mobilizing for months to preserve the integrity of the previous nutrition standards. Nonetheless, Sonny Perdue’s relaxed school nutrition rules go into effect this month, weakening a number of the standards laid out in the Healthy, Hunger-Free Kids Act (HHFKA). The USDA touts these rule changes as a move that provides more “flexibility” regarding what foods and beverages schools can serve, thereby potentially increasing participation in school breakfast and lunch programs. As nutrition policy experts are predicting meal quality will take a hit if schools take advantage of the new rules, the USDA’s logic runs counter to its own analysis that schools with the healthiest meals also have significantly higher participation. So, what changes were made, exactly? They include the following: Flavored 1% milks can now be offered as an alternative to fat-free flavored milks. Both contain nearly two teaspoons of sugar per 8-ounce serving, but the 1% variety contains roughly 10% of a child’s saturated fat limit for the day—a rather consequential nutritional difference. Whereas previously nearly all grain products had to be “whole grain-rich” (51% whole grain or more), now only half of these products must be whole grain-rich. Students in schools capitalizing on this change would consequently see the fiber and micronutrient content of their meals decrease from already sub-par levels. The sodium reduction targets put in place by the original HHFKA have been significantly weakened. The timelines have been shifted back several years, and the final and deepest reduction in the third target has been eliminated altogether. In practice, this means high school meals can contain as much as 1,420 mg of sodium for the next four school years instead of being capped at 740 mg by 2022. Additionally, the USDA passed temporary rule changes that, if implemented in schools, could reduce consumption of red-orange and dark-green vegetables, fruit, and legumes. Even more ludicrous, pasta made with vegetable flour will now count as a vegetable, and known disease-causing meats like nitrate-preserved sausage can be offered in place of whole grains at breakfast. Of course, just because the USDA has made these changes doesn’t per se mean schools will follow them, and from anecdotes, I know several districts plan to improve the healthfulness of their programs in defiance of the rule changes. Ultimately, how and whether the new rules affect student health are largely dependent on school nutrition professionals’ personal opinions and financial incentives, a fact that underscores how ironic the “flexibility” argument is. Yes, nutrition directors primarily focused on program participation might have an easier time boosting their numbers by dangling fries in front of pupils. But, in the bigger picture, the USDA is merely abdicating its responsibility of ensuring America’s children have access to the most health-promoting, nutrient-dense foods and is effectively passing that burden to local decision-makers whose motives lie elsewhere. If the USDA actually cared about child nutrition professionals and children’s health, the traditionally industry-pandering agency would pony up with more funding and better guidance for school nutrition departments so that small-town and resource-strapped districts would never have struggled to implement the original rules of HHFKA in the first place. But for the USDA, the solution appears to be to pretend that the problems of hunger and diet-related disease among children don’t exist, leaving many school nutrition professionals with hands tied and toeing the food industry’s line. Meanwhile, it’s no secret that school meals are more disliked than liked—just ask the average public school student or teacher. School food was corporatized decades before Perdue’s tenure at the USDA, and part of me wonders if his rule changes are more like throwing matches onto a fire than they are like setting one ablaze. We can argue that the rule change facilitating sales of à la carte items like pepperoni pizza will harm kids—but when the “healthy” option is a sad salad drowning in ranch dressing and served with cheese shreds and an egg, how meaningful is the difference? If I were heading the USDA and wanted to make the rules genuinely more flexible while also promoting children’s health, I would do the following: Reform the protein requirement and provide financial incentives and resources that will help schools offer more plant-based proteins and reduce consumption of ultra-processed and red meat products. If there’s one thing I hear over and over from directors, it’s that certain popular plant proteins are cost-prohibitive or haven’t been approved as a “meat alternate” by the USDA. Meat is not a standard against which we should base the value of a plant protein, so the entire “equivalency” model should be thrown out. Directors also say they need recipes or don’t know how to prepare certain plant proteins or vegetables, and the USDA—whose responsibility it is to promote healthy eating—needs to be involved in bridging that knowledge gap. Strike the dairy milk requirement and the associated restrictions on marketing plant-based milks. Obviously the dairy industry would lose its mind, but the fact is that there is no research indicating that American children who drink milk have better health outcomes than those who don’t. On the contrary, there are many health concerns associated with dairy consumption in childhood. Thus, as with meat, dairy should not be a standard against which we judge the value of plant-derived milk substitutes. Raise the reimbursement rates to $5 per meal and allow commodity dollars to be spent on a wider range of plant-based foods. Food prices pose a serious concern for school nutrition operations according to many working in the field. These common-sense changes would accommodate rising food costs as well as expand the range of fresh fruits and vegetables schools can purchase. Incentivize scratch cooking. The privatization of school food never fulfilled its promise of providing better-quality meals at a lower cost, and even with self-operation, too many of the foods served are still just heat-and-serve industrial products prepared offsite by corner-cutting food service companies. Scratch cooking, on the other hand, has the potential to increase participation, improve meal quality, increase produce consumption, and decrease saturated fat and cholesterol intake. All students would benefit, especially those facing hunger and food insecurity. Local, state, and federal governments can play more of a role in implementing these changes by, for example, providing more funding for kitchen equipment upgrades needed in our schools, which will cost billions of dollars nationwide, or funding positions for actual chefs within school districts. Incentivize longer lunch periods. When I was in high school, my fellow students and I were given barely 20 minutes to eat lunch, which is why I never bothered to wait in the long-serving lines and always brought my lunch instead. Research shows other students feel the same way. Moreover, kids with more time to eat waste less food. Thus, a combination of more time and healthier, higher-quality meals could increase participation and reduce waste—all without the need for rolling back nutrition standards. Imagine that! The state of children's health is unquestionably dire in this country, as are the rates of child hunger. The USDA—which abets industries that push disease-linked foods into schools, corner stores, and groceries—needs to do more, not less, to meaningfully improve children’s diets through greater access to whole grains, fresh fruit, vegetables, and plant proteins. Unfortunately, yet unsurprisingly, Perdue’s USDA has done a disservice to American children by cozying up to major corporations and implementing hands-off, do-nothing policies, then veiling its corporatist posture with the ridiculous notion that its rule roll-back “helps” the professionals at the frontlines of a health crisis the agency refuses to acknowledge. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org To request information about balancing your institution's menu and receive support (FREE!) one-on-one support from Maddy in doing so, please email Maddy directly or visit our Institutional Support page. From there, you can download a step-by-step guide and get started today! Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

This week on the Balanced Blog, guest contributor Jendi Brooks, takes a look at the connection between digital marketing, unhealthy food, and negative health outcomes for our children and families. One of the greatest threats to public health in the last twenty years is the prevalence of childhood obesity. NCBI reports that 170 million children below the age of 18 are either overweight or obese, and sadly, the computer use that has become second nature to today’s children is a major factor for this. Today’s kids are also very familiar with social media, which they can access easily through multiple devices – all of which allow companies to easily target them. In this post we will look at the connection between digital marketing and unhealthy food. A tool for success Modern technology means more customized advertising techniques that target children through pop-up ads that appear while they’re playing online games or checking their social media feeds. Digital marketing now attracts great ad attention and recall, thus creating better brand awareness and intent to purchase. Maryville University’s online marketing degree page highlighted this trend, claiming that digital ad spending is expected to break the $335 billion mark this year. Considering the internet’s advantage over traditional media and the amount of money invested in online advertising, digital marketers, especially those that promote unhealthy food, are able to effectively target their top, and most vulnerable, customer bases. Policing content YouTube, as one of the main digital marketing players, decided to update its ad policies for children’s content. These policies cover food and beverage advertising in content aimed at children. A prominent critic of YouTube’s child-directed content, Senator Ed Markey emphasizes his disdain for advertising policies that do not take into consideration the impacts of the platform on young minds. Although this includes targeted and unhealthy advertising, more needs to be done in terms of establishing restrictions against manipulative marketing campaigns that lure children because they’re promoted by favored influencers. YouTube’s shift to a more stringent advertising policy is a step in the right direction. A one-sided approach Previously, The Power of Parents discussed how it appears that the food industry’s main concern is to capitalize on children and parents by investing in billions of dollars worth of junk food advertising. As idealistic as it is to impose rules for this type of advertising, food and agricultural policy scholar Robert Paarlberg is skeptical of its success. He notes that food ads are also a form of commercial protected speech. The issue has been brought up as a matter to be discussed by the Supreme Court. While altering the advertorial content of unhealthy food should be an institutional change, it may not be wise to be fully reliant on these stakeholders to follow through, since it is an income-generating business. It is, however, an important healthcare concern. In the meantime, parents, guardians, and even teachers, should make it their goal to help filter out the content their children or students consume and teach them the importance of responsible viewership. This is a step towards fighting the good fight; pushing for a healthier and more critically-aware generation. Article exclusively for balanced.org By Jendi Brooks Editor's note: at Balanced, we generally avoid using the term "obesity" or focusing specifically on body size as a negative health outcome, that being said, we recognize the term is often used in medical and public health literature and a lot of data is organized around this term, which is why it is used in this guest post.

Last week, the U.S. Department of Agriculture (USDA), led by Sonny Perdue, released a proposal for changes to the Federal Nutrition Services school meal guidelines. Guidelines that, at their best, promote healthy meal patterns for the 30 million children who depend on them each day. At their worst, however, those same guidelines limit the quality, healthfulness, and diversity of foods on school menus. We've all seen them at their worst. Cue all the beige: So on the surface, it would seem the USDA’s proposal to “increase flexibility” for school foodservice providers and “streamline the accountability process” would be news welcomed by public health advocates and foodservice professionals alike, right? Wrong. Despite its reckless attempt to use buzzwords like “flexibility” and “streamlining” to mislead the public, it’s clear the actual goal of the USDA’s proposal is to make it easier for the food industry to influence school menus. While the agency may indeed successfully confuse millions of parents who trust it to make decisions in the best interest of their children, nutrition policy experts and public health advocates have been working overtime to reveal the USDA’s real motivation for the changes they’re championing. Of the USDA’s proposal and associated press release, Bettina Elisa Siegel author of Kid Food: The Challenge of Feeding Children in a Highly Processed World, says this “But to read the U.S. Department of Agriculture’s (USDA) press release about its proposed rule—a masterwork of doublespeak—you’d never know what’s really going on.” The Center for Science in the Public Interest released this statement following the USDA’s announcement, “[this] assault on children’s health continues today under the guise of “simplifying” school meals. The proposed rule would allow anything that might be allowable as an entrée on any one school day to be served as an a la carte item every single day. In practice, if finalized, this would create a huge loophole in school nutrition guidelines, paving the way for children to choose pizza, burgers, French fries, and other foods high in calories, saturated fat or sodium in place of balanced school meals every day.” After exclaiming, “I just can’t get my head around why there is so much political pressure to feed junk food to kids. Doesn’t everyone want kids to be healthy? Apparently not.” Marion Nestle continues on her blog Food Politics, “In short, school meals are not broken and do not need fixing. This is about politics, in this case USDA’s pandering to food company interests at the expense of kids’ health.” Unsurprisingly, apart from the USDA itself, the only organization to endorse the proposed changes happens to be the School Nutrition Association. Not coincidentally, the SNA receives the majority of its funding from the very food companies that stand to benefit the most from loosened regulations and accountability. Public comment on these proposed changes opens on January 23rd, and concerned citizens are encouraged to comment. Although if history has shown us anything, public comments have-not-been and will-not-be enough. At least not right now. A healthier future depends on policymakers putting our lives - our wellbeing - above the corporate and political interests (and money) of the food industry. --------- If you would like to leave a public comment on/after January 23, 2020, here is our suggested language: It is incomprehensible that the agency responsible for ensuring the nutritional quality of the over-30-million meals served to children every day, has yet again turned its back on the health of our families. The “flexibility and streamlining” of the proposed changes to the FNS School Meal Guidelines will almost certainly result in imbalanced, unhealthy meals and open the door to increased amounts of ultraprocessed foods high in sodium, cholesterol, saturated fat, sugar, and excess calories on menus. These changes clearly put the interests of the food industry and agribusiness ahead of the health and wellbeing of our children, families, and communities and the American people deserve better. Audrey Lawson-Sanchez is the founder and executive director of Balanced. To share your thoughts or for media requests, please email: audreys@balanced.org Follow Balanced on Twitter, Instagram and Facebook for daily updates and ways to get involved.

Ask the typical American how to eat healthfully, and you’ll probably get a vague response like, “Oh, you know, it’s best to eat a balanced diet with everything in moderation.” But “balanced” — according to the best nutrition science — is not at all synonymous with “everything in moderation.” This is where so many people, from the average layperson to the registered dietitian to the medical doctor, get it wrong. Maybe you’ve caught yourself thinking, “I’ll have a salad for dinner to make up for the cheeseburger and fries I’m eating for lunch.” (Most of us can recall a time when we’ve made similar rationalizations.) In our society, this passes for “moderation,” yet, in this scenario, the burger and fries will contribute more than a third of total daily calories. When this happens every now and then, it’s fair to say that is moderation, but based on standard American dietary patterns, many of us tend to do this multiple times a week. True balance, then, means going heavy on health-boosting foods, which preferably constitute well over 90% of what we consume. Naturally, this entails reducing how much and how often we eat foods that are contributing to diet-related disease—and over 800,000 Americans’ deaths each year. While it is certainly a good thing to moderate our consumption of foods that are known to contribute to diet-related disease, we, as a culture, have a very skewed sense of where moderation stops and overconsumption begins. Not being able to distinguish between what is healthy and unhealthy is another big problem for us. Thus, when each of us defines vague terms like “moderation” and “healthy” at our own discretion, we tend to do so very liberally. That’s because we like to see all foods as being equal, when in reality there’s simply no equivalency between, say, Brussels sprouts and sausage. Green veggies and processed meats have drastically different effects on the body. We know this intuitively, and yet, we struggle to act on this knowledge. This, in turn, is because our food environment is dominated by industries that have relentlessly marketed disease-promoting foods as “wholesome” and “good for us” and “protein-rich” and so on. In fact, co-opting the concept of “balance” is a primary strategy of the food industry. For many of us, achieving true balance in our diets is no small feat. With many Americans having some combination of little time, little money, little know-how, or simply no energy to plan ahead, it is imperative that the institutions we rely on to feed us create environments conducive to truly balanced eating. In achieving balance, greater weight must be given to foods rich in fiber, minerals, vitamins, and antioxidants. These include legumes, whole grains, vegetables, fresh fruits, nuts, and seeds. At the same time, we as a society need to deemphasize foods that, when eaten regularly, lead to negative health outcomes. These include meat, high-fat dairy, eggs, fried foods, pastries, and ultra-processed snacks. Combined, these foods should comprise not much more than 5% of our total calories—and the lower, the better. Of course, that’s not to say we can’t eat those foods at all or that institutional food service shouldn’t serve anything remotely indulgent. However, institutions have the opportunity to model true balance in their food environments for a population that has, for generations, been made to believe that “balance” equals “everything in moderation.” To illustrate the concept in more tangibly, here’s an example of a full day’s menu of more balanced meals. For breakfast: a steaming bowl of steel-cut oats with cinnamon, sliced banana and strawberry, chopped walnuts, and a drizzle of maple syrup; fortified unsweetened soy milk to drink. For lunch: a slice of veggie pizza and a hearty salad composed of greens, mixed raw veggies, chickpeas, toasted pine nuts, and a lemony herbed vinaigrette; water to drink For snacks throughout the day: spiced mixed nuts, hummus with mini pretzels, an apple For dinner: potato and cauliflower masala served with brown rice and a dollop of plain yogurt; table grapes; water to drink For dessert: an oatmeal-raisin cookie with a glass of fortified unsweetened soy milk Note: Since this day’s menu did not include a whole-food iodine source, it would be best to cook with a little iodized salt, take a supplement, or incorporate sea vegetables regularly throughout the week Balanced eating can be easy, enjoyable, and energizing. Far from leaving us sluggish and prone to illness, it helps power us through our busy days. And all it really takes is a new, more intentionally plant-rich way of structuring our menus, our food environments, and our pantries—and not falling prey to the moderation myth! Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org To request information about balancing your institution's menu and receive support (FREE!) one-on-one support from Maddy in doing so, please email Maddy directly or visit our Institutional Support page. From there, you can download a step-by-step guide and get started today! Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

When I was a child in the mid-1990s, I found a book in our makeshift home library about the future. Written sometime in the late ’70s or early ’80s the book outlined a number of predictions about what the world would be like in the 2000s. The offwhite pages and purple line-illustrations were pretty rad, and the ideas listed blew my little seven-year-old mind. Hard to believe that between 1990-something and 2019, we still haven’t perfected the craft of transporting our likeness through time and space using pocket-hologram machines. I suppose Facetime is a nice consolation prize, though. Now, I cannot for the life of me find that book in my parent’s basement, but I do remember a few of the predictions that really rocked my world: A pair of glasses that could project television right onto the lens. What a treat! Cars capable of driving themselves. A cure for cancer. Entire meals that came in the form of a pill (or a few pills) Check! Check! Not yet. Nope. But, considering there were thousands of additional predictions in the book, it’s not unlikely the futurists of the time got a lot of other things right. However, one thing I don’t remember reading about, a topic that certainly would have been hard for most people to imagine four or five decades ago, is the state of public health heading into 2020. Obviously, I have no first-hand knowledge, but I struggle to imagine a world in which people thought ahead to the year 2020 and assumed - collectively - we’d be less healthy than ever before. If anything, it would seem counterintuitive for people in the 1970’s to imagine a post-2000 future in which nearly half of American adults live with one or more preventable, chronic, lifestyle-related disease(s). Or a world in which our children are predicted to have a shorter lifespan than us because of skyrocketing rates of diet-related disease(s). I doubt futurists of the time could have predicted unhealthy diets would be cited as the leading cause of disease and disability, and contribute to the death of upwards of 700,000 Americans annually. Yet, here we are. As a country, we’re heading into the 2020s less healthy than any time in recent history. Despite an endless amount of nutrition information *LITERALLY* in the palm of our hands and in the face of relentless diet-culture promoted in media of all sorts, our families are experiencing unprecedented rates of heart disease, stroke, type-2 diabetes, high cholesterol, hypertension, cancer, and other chronic illnesses. A fact that would undoubtedly shock our friends, the 1970s futurists. So how did we get here? As a society, did we somehow become lazier or less concerned with our health? Have we stopped caring about our children? Do we just enjoy paying increased health-care costs or experiencing an unnecessarily diminished quality of life as we age? Of course not. In fact, given the pace of our lives, personal and professional expectations, economic considerations, and increased social pressure, it’s probably fair to say we care more about our health, money, and quality of life than ever before. If that’s not true, then Instagram’s business model is in trouble. So if we - the people in this equation - haven’t changed the things we want for ourselves and our families, and we have the information we need at our fingertips, why aren’t we getting healthier instead of the other way around? Well, one critical thing our future-thinking friends of the 1970s couldn’t predict was the dramatic transformation of our food system and community food environments. They couldn’t predict the way our food environments would come to influence our food choice or the ways the food industry would leverage those food environments to maximize profit with little regard for human health. But that is exactly what has happened. For too long, the conversation about nutrition and health has focused almost exclusively on personal choice and willpower, lackluster or indulgent parenting, and cooking skills (or lack thereof). Meanwhile, the food environments in our schools, hospitals, restaurants, grocery stores, offices, corner markets, etc… have grown increasingly less healthy. A fact that for many, completely nullifies the personal choice argument. After all, the child who depends on school lunch has little authority when it comes to the foods they’re served. In her article “This is why child obesity rates have soared,” Sara FL Kirk, Professor of Health Promotion at Dalhousie University notes, "There is a pervasive narrative of personal responsibility for obesity, particularly among the general population. This suggests that people gain weight because they cannot control themselves, because they are weak or morally flawed or because they choose to eat unhealthy foods when other healthy options are available...Obesity is not a character flaw. It is a normal response to an abnormal environment." When we zoom out to examine public health over the decades and look closely at the changes that have occurred in our food environments over the same period, the influence the latter has had on our families is obvious. It’s not some grand coincidence that 60% of the Standard American Diet is made up of ultra-processed food products. Or that we’re consuming twice as much animal protein, sodium, and sugar than recommended. 9 out of 10 of us are not accidentally eating too few fruits and vegetables. Clearly, abnormal environments we have aplenty. The current diet-related public health crisis is too massive to have happened by chance. It didn’t happen because of the personal-failings of 300 million-plus individuals. Yes, individuals are making choices, but within a system that values our health very little. We’re simply responding to the food environments surrounding us, and - one more time for the people in the back - as our food environments have become less healthy, so have we. As adults, we’re making choices from predetermined menus and store shelves stocked with cheap (but undeniably delicious) food type products. Worse still, we’re asking children to do the same with even less agency and influence. In all fairness given the circumstances, most of us would argue we’re doing the best we can - for ourselves and our families. So even if we have some semblance of personal choice, that choice is only as healthy as our food environments allow. Logically speaking, that means if want healthier families in the decade to come, we need healthier food environments in our communities. To quote Professor Kirk once again, "There can be no dispute that everyone has a right to good health. But if we want to improve the lives of everyone, from the youngest to the oldest, wherever they live in the world, then we must, as a society, commit to making healthy choices easier for everyone to adopt." Although many technological advancements have been made in the years since, like our friends in the 1970s, we still can’t predict the future. Regrettably. But unlike them, we have the benefit of hindsight. What we do with it matters now more than ever. Heading into this next decade, we have to decide what we want for our families. We can continue to place the blame on individual people, parents, and/or communities. Or, we can call attention to the root of the problem and demand better from the institutions and people who serve our families. We can’t afford to waste another ten years fighting one another, so let’s advocate for change in our schools and hospitals and spend the next ten years championing policy change with our elected officials. Now is the time to fight for a healthier food system. Not ten years from now, and not ten years ago. We can’t change the past but we can have hope for the future. And even if we can’t fully predict what’s to come, we can work hard to create the future we deserve.

Here in the United States, what we think of as a “normal” diet really has no historical or cultural precedent. At no other point in human existence could we so readily access the smorgasbord of high-calorie, nutrient-poor foods that abound in grocery stores, restaurants, and cafeterias today. Through globalization, these changes to the food environment have spread rapidly to countries in Asia, Latin America, and Africa. As a result, where local food traditions based predominantly on regional flora once flourished, increasingly “westernized” patterns of eating have come to dominate. Traditional, plant-rich meals are making up ever smaller proportions of people’s diets across the world due to the influx of highly palatable, western-style foods that are pushed through insidious marketing strategies. A number of other factors, like the industrialization of animal agriculture and a rise in household incomes globally, have enabled previously-unknown access to animal products and other refined foods high in saturated fat, cholesterol, and sodium. Unsurprisingly, the growing consumption of meat, ultra-processed foods, and sugary beverages is contributing to a public health epidemic that is now global in scale. And it’s happening in places you wouldn’t expect. For example, Ghana’s obesity rate has risen to a whopping 22%. After Egypt, it has the second-highest obesity rate in Africa, and many other rapidly urbanizing countries on the continent predict similar public health outcomes in the near future. Likewise, in Delhi, India, nearly 50% of the population experiences overweight or obesity, and one in three households has at least one diabetic member. These are shocking statistics rooted in imbalanced food environments similar to those in North America or Europe. And while there are many factors involved in this burgeoning epidemic, it is the concurrent erosion of local food culture and public health by the over-industrialization of diets that I find particularly troubling. With a change in food environment come changes in eating habits and preferences, and those in turn ossify into a shared lifestyle that can put whole populations on a trajectory toward diet-related disease. Moreover, and perhaps of even more significance, this process erases the traditions and history of plant-rich food cultures to such a degree that, within just a generation or two, they are all but forgotten. For example, as a second generation Filipino-American, I was only exposed to cultural foods that were westernized or most agreeable to the western palate; white rice, processed pork products, refined wheat rolls, and chicken adobo come to mind. However, in a time preceding the rise of fast food, and in a place largely naive to industrialized agriculture, my grandparents grew up eating an astounding diversity of local produce, including many tropical fruits, vegetables, beans, and leafy greens—many I’d never heard of. In a phone call with my grandma, she waxed nostalgic about the fresh foods of her youth, which she spent on her family’s farm. She spoke of the abundance of tropical fruit trees, like mango, guava, and pineapple, and she remarked on the variety of other wild fruits that grew in her remote village. Daily meals consisted of rice, often a mixture of white and brown; legumes of all sorts, especially black beans and black-eyed peas; vegetables like okra, eggplant, tomato, sweet potato, and winged beans; and many different kinds of leaves, including malunggay, kangkong, ampalaya leaves, pitsay, and tomato leaves. These represent just a small sampling of the diverse plant-based foods my grandma grew up eating. Meat, poultry, eggs, and goat milk were consumed rarely—together, maybe a few times a month. As is typical of many food cultures, animal products were primarily used as flavoring agents. In Filipino cuisine, for example, fish sauce and sardines add saltiness and umami to many dishes. My grandpa, who grew up in a larger coastal city quite different from my grandma’s mountain village, ate a nonetheless similar diet consisting mostly of rice, vegetables, and beans. Because of their proximity to the water, his family could eat a little fish on a daily basis, too. I asked him to name the foods he remembers most from childhood, and he recalled vegetables like beets, string beans, and bok choy; monggo (mung) beans; star fruit and citrus fruits like calamansi; macapuno (young coconut); and grains like wheat and corn. He also recalled eating plenty of bean thread noodles called sotanghon, which are often used in soups. Meat other than fish was typically reserved for holidays, and milk products in the form of evaporated or condensed varieties were eaten sparingly. Contrast these “historical” accounts of the Filipino diet with contemporary foods from the Philippines’ most beloved fast food restaurant, Jollibee. The franchise operates around 1,000 locations in the Philippines, and its most popular items include fried chicken, hamburgers, and spaghetti with sugary marinara and sliced hot dogs. Jian DeLeon, a Filipino expat living in the United States, remarked that Jollibee’s food “captures the Philippine palate perfectly” and that the franchise has become “a symbol of the Philippines itself.” DeLeon’s comment illustrates the extent to which health-promoting food traditions have been rapidly degraded by the westernizing forces of the global food industry. In my opinion, it is entirely wrongheaded to claim that a fast-food corporation selling largely American-origin foods is an appropriate stand-in not just for Filipino cuisine, but for the Philippines as a whole. It’s clear that perceptions of our food culture have been warped by the lens of western sensibilities, and it’s led to a cultural amnesia that obscures our history of traditional, plant-rich food ways that some Filipinos still practice today. Yet, there may be a kernel of truth to DeLeon’s remarks. A 2018 Statista poll showed that 60% of Filipinos consume fast food one or more times per week, and around 15% of the population eats fast food four or more times per week. Likewise, the Philippines’ rates of overweight and obesity have grown in tandem with its rates of cardiovascular disease, cancer, and diabetes—now among the country’s leading causes of death. Even closer to home for many Americans, perhaps the most egregious example of food culture erasure is that suffered by the many indigenous groups of North America. Unsurprisingly yet tragically, this segment of the population is plagued by the most dire health circumstances of any other racial or ethnic group in the United States. Fully three-quarters of all American Indian and Native Alaskan adults are obese or overweight, and they experience rates of heart disease twice that of the general population! However, these shocking rates of chronic, diet-related disease have only developed within just the last few generations as the American Indian diet became increasingly saturated with canned meats, sugary beverages, cheese products, and other ultraprocessed foods. Of course, this wasn’t the result of a willful rejection of traditional foods. Rather, it was due to the losses of ancestral lands and the ability to practice traditional farming and food-gathering, exacerbated by the influx of convenience stores and lack of grocery stores on reservations. Compare this corporate-colonized diet to the traditional foodways of Native Americans. Although every tribe had its own unique approach to food and nutrition, many indigenous peoples—like the Choctaw, Cherokee, and Hopi—consumed diets largely based on corn, beans, squash, and a multitude of cultivated and wild vegetables, fruits, nuts, and seeds. Historical accounts and nostalgic anecdotes aside, none of this is to say that there is no value in industry, global trade, or technology or that American food culture has nothing positive to contribute to a gastronomy of health. And just because something is “ancient” or “natural” or “traditional” doesn’t mean it’s optimal or relevant today. I am typically not one to blindly celebrate traditions for their own sake, but as a nutrition scientist and public health advocate, it’s impossible to overlook the connections among the domination of an aggressive, profit-driven food industry, the loss of meaningful, plant-rich food cultures, and the global epidemic of diet-related disease. The systems-level forces eroding both our health and the wisdom of our plant-rich food cultures must ultimately be met with systems-level changes—and those will entail much more than a handful of people adopting their ancestors’ diets. Nevertheless, individuals and communities have much to gain from rediscovering the wiser aspects of traditional ways of eating that support good health and cultural awareness. And, at their best, they can inspire alternatives to the rapacious, profit-driven food system that continues to spread diet-related disease to all corners of the planet. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org To request information about balancing your institution's menu and receive support (FREE!) one-on-one support from Maddy in doing so, please email Maddy directly or visit our Institutional Support page. From there, you can download a step-by-step guide and get started today! ___________________ Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

As part of its ongoing pro-industry campaign, the current USDA leadership dealt another blow to Amercians’ health in ensuring that the 2020 Dietary Guidelines Advisory Committee will not discuss the health impacts of three of the most health-eroding components of our diets—red and processed meat, sodium, and ultraprocessed foods. Combined, these foods make up the vast majority of the average American’s diet and encompass a broad range of items, including chicken nuggets, fish sticks, deli meats, sausage, sugary breakfast cereals, frozen pizza, commercial baked goods, and much more. At the same time that this panel of largely industry-backed nutrition “experts” determines what our national dietary guidelines should look like, it refuses to address roughly two-thirds of what this country actually eats every day. To those of us who can go on leading our lives unaffected by the politics and results of this panel, changes to the current guidelines may not seem like a big deal. But because the guidelines form the basis of federal school lunch and breakfast programs and nutrition assistance programs, the most vulnerable Americans—infants, children, families, and older adults in resource-deprived areas—could be harmed by lowered nutrition standards. That includes 30 million children who depend on free or reduced-price school lunch, 40 million people who rely on SNAP, and 7 million women and children who benefit from WIC, among others. According to official statements from the USDA, the agency is preventing a duplication of efforts made by the 2015 iteration of the Dietary Guidelines Committee, but the veracity of this claim is doubtful. For example, regarding sodium, we’ve known for many years that excessive consumption is directly implicated in cardiovascular disease and stroke (deaths from which are currently on the rise), high blood pressure, and even the worsening of asthma (also on the rise, especially among kids). Yet, in a predictably partisan ploy, Sonny Perdue and the USDA delayed and annulled pre-scheduled sodium reductions in school meals to the detriment of every student participating in the school lunch program. In light of the USDA’s blatant dismissal of scientific evidence, it’s obvious the Dietary Guidelines Committee would benefit from more conversations on the harms of excess sodium intake, not fewer. And if the USDA and its committee won’t create fact-driven policy around a politically neutral additive like salt, it’s unlikely that the committee will acknowledge the very real risks attributed to ultraprocessed junk and processed meat. This is despite the fact that nutrition science has repeatedly demonstrated that red and processed meats are carcinogens. Moreover, scientists increasingly understand that ultraprocessed foods, which alone make up over half the average American’s diet, are linked with higher risk of early death and diet-related diseases. Alas, in blocking substantive discussions about the scientific evidence, this cowardly panel is derelict in its responsibility to the American people out of its fear of censure from the industries who are backing it. Still, one would think, given its lax timeline for deliberation and completion of the guidelines, that the committee would want to prioritize addressing the health-harming components of our diets, especially when those components account for most of the calories we consume. No matter the efforts nutrition advocates are making on the ground to plug holes in lenient government policies, they won’t be enough to prevent all the possible damage those holes might inflict. Specifically, if regressive changes are made that seek to expand the food industry’s profits from ultraprocessed foods and cancer-causing meats, there will be an inevitable toll to be borne by the vulnerable groups who depend on nutrition assistance and whose diets may already be marginal to begin with. The 13 industry-backed committee members, Perdue, and the current administration have shown a clear preference for agribusiness and food industry interests at the expense of public health and everyday people. But our children and loved ones are too important for this powerful group to have the last word. Ultimately, the 2020 Dietary Guidelines Committee has exposed the vulnerability of this country’s nutrition policy to industry corruption—and it is a vulnerability built into the system. Now more than ever, we need to separate nutrition policy from corporate interests through the creation of an independent agency devoted specifically to nutrition science and food policy. Only then will our dietary guidelines and our nutrition assistance programs have the integrity we deserve and the unbiased scientific rigor we need to effectively improve public health. To support our efforts and demand better for our families, please sign the petition and get involved at betterguidelines.com. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org To request information about balancing your institution's menu and receive support (FREE!) one-on-one support from Maddy in doing so, please email Maddy directly or visit our Institutional Support page. From there, you can download a step-by-step guide and get started today! ___________________ Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

Last week, I spent two days at the School Nutrition Association (SNA) Annual National Conference in St. Louis, Missouri. For our readers who don’t know what SNA is, it is the professional organization of school food service, and it boasts nearly 60,000 members nationally. The conference itself hosts an exhibition where food service providers, business software and kitchen supply companies, well-known and mom-and-pop food retailers, and a handful of nonprofits are set up in a seemingly endless maze of booths. Integral to the conference experience are dozens of education sessions ranging in topic from staff management to food allergies to labor shortages. Having never attended, I walked into the conference center with few expectations but was immediately struck by the unabashed corporatism of the event. The hallway leading to the exhibition was dotted with display cases housing sugary cereals, cinnamon rolls, and other familiar packaged products with name brands. It was a small taste of what was waiting for me in the exhibit hall itself. To give you a sense of the hall’s vastness, I spent well over three hours meandering through the booths, sampling products, chatting with sales reps, and collecting free trinkets like tote bags and pens. I could see how easy it would be to get swept up in the razzle-dazzle of the raffles, flashy displays, and corporate-sponsored afterparties—not to mention a fair bit of flamboyant schmoozing. On the whole, the atmosphere was a self-congratulatory celebration of the Standard American Diet, as if Big Food and Ag were throwing their own surprise birthday party. Though nothing I saw was too obscene, watching food service professionals take photos with people dressed as the Lucky Charms leprechaun and Cheetos cheetah was definitely beyond the pale. Yes, there were many disheartening sights, like booths dedicated to smoked meats and donuts and pepperoni pizza, but there were the occasional glimmers of hope, too. For example, there was evidence that some companies are embracing the emerging trend of plant-forward menu items. I was immediately drawn to the Dr. Praeger’s booth, where bites of plant-forward and plant-based proteins were taste tested. I sampled a veggie noodle bowl, dragonfruit, “fried” brown rice with soybeans, mango salad, plantains, and a flavorful bean chili—all from a small handful of well-established vendors. There were other indications that plant proteins are on SNA’s and companies’ radar screens; soy beverages, faux meats, and chickpea snacks found their way into the exhibition. In this regard, plant-derived entrees and snacks are gaining a bit of ground, but only at the pace and to the extent that large food service providers are comfortable with it. At the end of the day, companies will make what sells and exploit dietary trends not for the sake of kids’ health, but for the sake of tapping into all niche markets. Like SNA, these companies boast their “inclusivity” of plant proteins, but I’ve found that term to be little more than progressive whitewashing for marketing purposes. Inclusivity, almost by definition, precludes criticism of existing bad practices with real health-harming outcomes. However, it’s clear the SNA recognizes the growing need to diversify the proteins on their menus and make adding plant-rich entrees a priority. To it's credit, the conference did offer a powerful educational session on plant-based proteins, led by two exuberant child nutrition professionals from Boston Public Schools and Burlington School District. Together, they expounded why school food teams should care about adding plant-based entrees to their menus and offered practical insights into the menu change and compliance processes. It was certainly refreshing to see well-respected professionals encouraging their colleagues in other districts to lean into the idea of more balanced food environments. All in all, SNA has a long way to go if it wants to embody its purported values of being brave and promoting evidence-based nutrition. I don’t see the organization indicting and renouncing processed meats or sugary packaged convenience items anytime soon—not when major sponsors of its conference include Jennie-O, Tyson, Domino’s Pizza, General Mills, and ConAgra. Still, it was evident many of the professionals who attended are deeply committed to the students and communities they serve. I take solace in knowing there are dedicated school nutrition professionals who really care, who fight the good fight, and who do the best they can with the information and resources they have. And at Balanced, we’ll play our part by supporting them in our work everyday.

This morning as I was going through my daily nutrition Google Alerts, one story caught my eye. It was about a school district that won a national nutrition award by teaching children about different fruits and vegetables with the help of a chef-hat-wearing mascot. I am not going to share the name of the school district because honestly it’s almost irrelevant. The more relevant part of this story is what happened when I finished reading the article. In an effort to find out the nutrition standards worthy of an award, naturally I looked up the featured district’s lunch menu. Surely, if they won a national nutrition award and everything they shared in the article is true, then the menu must be incredibly healthy right? Wrong. At this point I should be used to disappointment and it’s fair to say my expectations are generally very low to begin with, but somehow this menu managed to shock even me. Take a look for yourself: On the surface this menu looks pretty bad, but still I thought, the nutrition facts might tell a slightly different, more positive story. They did not. One entree item shown below contains 1,129.547 mg of sodium. For context, that’s roughly half the daily limit recommendation for adults. Shockingly, the CDC warns that 9 out of 10 children in America consume too much sodium and 1 in 6 already have high blood pressure, putting them at risk of developing a number of diet-related diseases. Another menu item, the Country Fried Steak has 50 mg of cholesterol - a quarter of the upper limits allowed for adults. The American Academy of Pediatrics has published a number of papers outlining the dangers of children over-consuming foods high in cholesterol, and many lifestyle medicine practitioners note there is no safe amount of dietary cholesterol recommended for daily consumption. Both groups point to the fact atherosclerosis begins in childhood and unhealthy dietary patterns are almost singularly responsible for our country’s leading killer: heart disease. Yet and still, here we are: giving school districts nutrition awards for menus dominated by known disease-causing foods. Jumbo corn dogs, gravy every-other-day, breaded and fried pork and chicken, red meat most days, and let’s not forget the slushy that counts as a fruit more than once on this menu. By no means am I trying to shame this one specific school district. I understand how hard their jobs are and I do not envy their profession. I am trying to point out a much bigger systemic issue in which we hand out awards for getting children to eat rutabaga one time while feeding them calorie-dense, nutrient-poor, disease-causing meals five days a week. I’m pointing out that ~maybe~ we've lost sight of reasonable nutrition guidelines, and ~perhaps~ we're not really questioning whether the foods served to our children actually promote health or just kind of taste good. There is no easy way out of this mess. The scale of the problem is incomprehensibly large, which is why it will require dedicated people in communities all over the country to organize and advocate for change. No one top-down solution will work for every school district or institutions, but I have abundant hope in community-led advocacy. Community-led initiatives in which the people directly affected are empowered to speak up and take action are incredibly powerful, especially when it comes to the health of our families. Each of us is best positioned to make change in the places closest to home -- the places that matter most to our families. I know how much we love our children and how far we're willing to go to keep them safe and healthy, so if we're being honest, standing up for healthier menus isn't even that far. Obviously, there will be no awards for this kind of work. The proof is in the (healthy-ish) pudding and it doesn’t look like awards hanging in a foodservice office, it looks like more balanced menus hanging on the lunchroom wall. It looks like healthy children, families, and communities. ---------------------------------------------- Audrey Lawson-Sanchez is the founder and Executive Director of Balanced. She spent the better part of a decade working in public education before becoming a mother and realizing her true calling: fighting for the health of every child and every family. You can contact her by email: audreys@balanced.org Follow Balanced: Facebook: facebook.com/getbalancednow Instagram: @getbalancednow Twitter: @getbalanced_now Balanced is a registered 501(c)3 and we rely on donations to keep our programs running and free to the public. Please make a donation to support our advocacy today.

As Balanced’s Advocacy Manager, I spend pretty much all day, every day talking about how the imbalance of our food system is leading to our communities being both over- and undernourished. Too many products high in saturated fats and cholesterol like meat and eggs, too many refined grains and over-processed food products, not nearly enough fresh fruits, vegetables, or legumes. And it is always my honor to pass along what I have learned to parents, grandparents, and other concerned community members so they feel empowered to make change in their local community institutions. But as much as I already know about how our current food system is making us sick, last week I read a story that brought my day to a screeching halt. The Washington Post covered a story that a school district in Rhode Island will begin denying warm meals to its students with lunch debt. While their peers will be walking through the line picking up a chicken parmesan melt or a cheese omelet with bacon, these students will be given a sunflower seed butter and jelly sandwich. Talk about overnourished and undernourished. The stark contrast of these offerings perfectly exemplifies the brokenness of our food system and how it fails our children every day. While some students are served heaping helpings of foods we know cause disease, others are denied a warm meal with any semblance of nutritional balance, and the consequences are severe—physically, intellectually, emotionally, and socially. The problem of lunch debt isn’t new, and it certainly isn’t an isolated case. One school district in Colorado fired a cafeteria worker for feeding children who couldn’t pay for lunch. Students at schools in Utah and Pennsylvania who can’t pay for lunch get their meal taken away and thrown into the trash (at one point, 40 lunches in one day). Another school in Alabama literally stamps children’s arms with the words “I Need Lunch Money” (with a smiley face added for that personal touch). At such a tender age, these children have to walk around the lunchroom branded with the reminder that their parents can’t afford to pay for them to eat—the social harm of which is just as damaging. A full 1 in 6 children experience food insecurity in the United States, and another 4.1% have very low food security, meaning they may not receive enough food for an active, healthy life. Taking into account that school children often get roughly half their calories from their school meals, we must do better for these children. According to the School Nutrition Association, 75% of districts have unpaid school meal debt. Unpaid school meal debt is the norm, and while the reasons for this are complex, one thing is abundantly clear: no child should ever have to suffer the consequences of a broken system. All children deserve a meal that doesn’t just stave off hunger pangs, but nourishes their growing bodies and promotes their long-term health and wellness—regardless of their family’s ability to pay. Food insecurity in childhood has devastating consequences, both for the individuals impacted and our society at large. Children who experience food insecurity get sick more often than their peers, and experience negative impacts on their physical, intellectual, emotional, and psychosocial development. When other children are having after-school snacks and extracurriculars, often students in food insecure households will take on extra jobs to contribute income and ease the burden on their parents, or in one case, develop a habit of sleeping to distract from hunger pangs (leaving no time for homework). Unsurprisingly, then, these children struggle in the classroom as well. Studies show that food insecurity literally changes the architecture of the brain and central nervous system, leading to lower academic achievement and increased social behavioral problems such as hyperactivity, aggression, and anxiety. (I mean, think about it. When you’re really hungry, are you energized and excited to sit in a chair for 8 hours a day and be talked at? Probably not.) Because today’s students are tomorrow’s workforce, the widespread problem of food insecurity puts our economic future as a country at risk as well. Adults who grew up food insecure are likely not as well prepared to perform in the contemporary workforce, leading to an overall less competitive workforce pool. The long-term health consequences of food insecurity in childhood can lead to greater absenteeism, presenteeism, and turnover in the workplace, all of which are huge financial costs for employers. And if that’s not enough reasons to care about this issue, here’s one more: it’s also just wrong to deny a hungry, crying child food. And yet, that’s what our food system has come to. A simple Google search showed that the company responsible for the Rhode Island school district’s food service is Aramark—a company that earned $4.3 billion in the first quarter of this year alone. But as it's already become clear, this problem is bigger than one company. Every major food service company in the country profits from contracts with school districts, and each has their own way of managing school meal debt. For those of us who do this work, “lunch shaming” is just another example of our corporatized food system’s relentless prioritization of profit over the lives of our children. Big Food is robbing our children of their future—our future—right in front of our eyes. And it must change now. I don’t have all the answers or solutions. But I do know that our children deserve somewhere between a cheese omelet with bacon and a sunflower seed butter sandwich. They deserve a balanced food environment where they have the power to make choices that feel good, promote long-term wellness, and nourish their bodies and hearts. And I’m not going to stop until that’s the reality for everybody.